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Optimizing the early diagnosis of cardiogenic shock by minimally invasive monitoring of hemodynamics

Author: Gîrbu Lucia
Degree:doctor of medicine
Speciality: 14.00.37 - Anaesthesiology and Reanimathology
Scientific adviser: Victor Cojocaru
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Livi Grib
doctor habilitat, associate professor (docent)
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova


The thesis was presented on the 8 February, 2023 at the meeting of the Scientific Council and now it is under consideration of the National Council.


Adobe PDF document1.13 Mb / in romanian


CZU [616-001.36-02:616.127-005.8-07+612.13] (043.2)

Adobe PDF document 3.77 Mb / in romanian
168 pages


cardiogenic shock, minimally invasive hemodynamic monitoring, PiCCO, EchoCG


Structure of the thesis: The thesis consists of: introduction, four chapters, conclusions and recommendations, 196 titles of bibliography, 27 annexes, 117 basic text pages, 35 figures and 47 tables and the results are published in 23 scientific papers.

Aim of the paper: The comparative analysis (hemodynamic and metabolic aspects) of the management of cardiogenic shock, based on minimally invasive monitoring of hemodynamics by PiCCO technology; reasoning the diagnosis and treatment, identifying and determining the risk factors for mortality rate in cardiogenic shock. Research objectives: (1) The general characteristic of patients with cardiogenic shock compared to the efficiency of cardiovascular function management based on the data provided by PiCCO and the data obtained by echocardiography. (2) Analysis of the diagnostic discordances and argumentation of the treatment of cardiogenic shock, in the case of a hemodynamic approach through the prism of PiCCO and ECHO. (3) Evaluation of complications in the cardiogenic shock using PiCCO versus echocardiographic technology. (4) Identifying and establishing the mortality risk factors in cardiogenic shock based on parameters provided by PiCCO and ECHO.

Scientific novelty and originality: There have been identified the common risk factors for death occurrence in both groups of patients with CS. There were established cardiac and noncardiac complications which played an important role in the death of these patients and also overestimated the hemodynamic parameters and tissular perfusion, measured with ECHO vs PiCCO.

The obtained result that contributes to solving the important scientific problem in the thesis, consists of identifying the risk factors which are predictors of mortality in patients with CS.

Theoretical significance consists in the elaboration of the methodology for determining the risk factors of death in CS. The identification of risk factors recorded during the CS evolution, allows theorizing the mechanisms of CS occurrence, a fact that rounds up the existing theories.

Applicative value: Based on the criteria and diagnostic methodology developed, the practitioner can identify the presence of the specific risk factors and is able to establish the diagnosis of SC. The application of recommended preventive strategies reduces the death rate of patients with CS.

Implementation of scientific results: the research results were implemented in the clinical practice of CMH „Sfânta Treime” from Chisinau, as well as in the didactic activity of Nicolae Testemițanu’s SUMPh.