van Diepen S, Hochman JS, Stebbins A, et al. - Given that mechanical ventilatory (MV) support is needed in up to 88% of patients with cardiogenic shock (CS), researchers focused on the link between timing of MV initiation and mortality among patients experiencing CS. Favorable cardiovascular hemodynamic changes have been reported in relation to positive end-expiratory pressure (PEEP) in patients with CS and reduced left ventricular (LV) function. PEEP has been shown to lower pulmonary wedge pressure, LV afterload, myocardial oxygen demand, work of breathing, and improve cardiac index and oxygenation. In this population, the timely start of MV could theoretically reduce physiologic deterioration or the ischemic cascade and improve results.