Rosh Emergency Medicine Practice Test

After resuscitation from cardiogenic shock, what should be monitored to detect recovery?

1. Urine output

2. Blood work for enzymes

3. ECG changes

4. Patient's neurological status

The correct answer is: Urine output

Monitoring urine output after resuscitation from cardiogenic shock is crucial for detecting recovery because it serves as an important indicator of renal perfusion and overall circulatory status. In the context of cardiogenic shock, the heart's diminished ability to pump effectively can lead to inadequate blood flow to the kidneys, resulting in decreased urine production. As cardiac function improves during recovery, renal perfusion typically enhances, leading to an increase in urine output. This reflects not only improved cardiac output but also restoration of organ perfusion. While blood work for enzymes, ECG changes, and the patient's neurological status are indeed important components of overall monitoring in a post-cardiogenic shock scenario, urine output serves as a more immediate and direct reflection of cardiovascular recovery. Blood enzymes might indicate myocardial damage or stress, while ECG changes can reflect electrical activity and rhythm but may not provide a direct measure of organ perfusion or systemic circulation status. Neurological status is essential to assess, especially regarding brain perfusion, but it may not show changes as rapidly as urine output in response to improved cardiac function. Therefore, urine output stands out as the most specific and readily observable indicator of recovery in this scenario.