Need for a Cardiogenic Shock Team Collaborative—Promoting a Team‐Based Model of Care to Improve Outcomes and Identify Best Practices

Journal of the American Heart Association, Год журнала: 2024, Номер 13(6)

Опубликована: Март 8, 2024

Cardiogenic shock continues to carry a high mortality rate despite contemporary care, with no breakthrough therapies shown improve survival over the past few decades. It is time-sensitive condition that commonly results in cardiovascular complications and multisystem organ failure, necessitating multidisciplinary expertise. Managing patients cardiogenic remains challenging even well-resourced settings, an important subgroup of may require cardiac replacement therapy. As result, idea leveraging collective cognitive procedural proficiencies multiple providers collaborative, team-based approach care (the "shock team") has been advocated by professional societies implemented at select high-volume clinical centers. A slowly maturing evidence base suggested teams patient outcomes. Although several registries exist are beginning inform particularly around therapeutic strategies pharmacologic mechanical circulatory support, none these currently focused on team approach, multispecialty partnership, education, or process improvement. We propose creation Shock Team Collaborative-akin successful Pulmonary Embolism Response Consortium-with goal promote sharing protocols, education stakeholders, discovery how performance influence outcomes, quality, resource consumption, costs care.

Язык: Английский

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Left Ventricular Unloading With Impella Versus IABP in Patients With VA-ECMO: A Systematic Review and Meta-Analysis

The American Journal of Cardiology, Год журнала: 2023, Номер 208, С. 53 - 59

Опубликована: Окт. 7, 2023

Язык: Английский

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Mixed Cardiogenic-Vasodilatory Shock

JACC Advances, Год журнала: 2024, Номер 4(1), С. 101432 - 101432

Опубликована: Дек. 5, 2024

This state-of-the-art review describes the potential etiologies, pathophysiology, and management of mixed shock in context a proposed novel classification system. Cardiogenic-vasodilatory occurs when cardiogenic is complicated by inappropriate vasodilation, impairing compensatory mechanisms, contributing to worsening shock. Vasodilatory-cardiogenic vasodilatory myocardial dysfunction, resulting low cardiac output. Primary systemic insult triggers both dysfunction vasoplegia. Regardless etiology shock, hemodynamic profile can be similar, outcomes tend poor. Identification treatment initial complicating disease processes essential along with invasive monitoring given evolving nature states. Hemodynamic support typically involves combination inotropes vasopressors, few data available guide use mechanical circulatory support. Consensus definitions strategies are needed for this dangerous condition.

Язык: Английский

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Cardiogenic Shock

Critical Care Clinics, Год журнала: 2023, Номер 40(1), С. 37 - 56

Опубликована: Июль 6, 2023

Язык: Английский

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Triglyceride-glucose index is associated with the occurrence and prognosis of cardiac arrest: a multicenter retrospective observational study

Cardiovascular Diabetology, Год журнала: 2023, Номер 22(1)

Опубликована: Июль 27, 2023

Abstract Background Triglyceride-glucose (TyG) index is an efficient indicator of insulin resistance and proven to be a valuable marker in several cardiovascular diseases. However, the relationship between TyG cardiac arrest (CA) remains unclear. The present study aimed investigate association with occurrence clinical outcomes CA. Methods In this retrospective, multicenter, observational study, critically ill patients, including patients post-CA, were identified from eICU Collaborative Research Database evaluated. for each patient was calculated using values triglycerides glucose recorded within 24 h intensive care unit (ICU) admission. In-hospital mortality ICU primary outcomes. Logistic regression, restricted cubic spline (RCS), correlation analyses performed explore Propensity score matching (PSM), overlap weighting (OW), inverse probability treatment (IPTW) adopted balance baseline characteristics minimize selection bias confirm robustness results. Subgroup analysis based on different modifiers also performed. Results Overall, 24,689 1021 enrolled. significantly higher post-CA than those without CA (9.20 (8.72–9.69) vs. 8.89 (8.45–9.41)), had moderate discrimination ability identify overall population (area under curve = 0.625). Multivariate logistic regression indicated that independent risk factor in-hospital (OR 1.28, 95% CI: 1.03–1.58) 1.27, 1.02–1.58) post-CA. RCS curves revealed increased linearly related risks (P nonlinear: 0.225 0.271, respectively). Even after adjusting by PSM, IPTW, OW, remained experiencing CA, which age, BMI, sex, etc. Correlation negatively correlated neurological status Conclusion Elevated associated Our findings extend landscape diseases, requires further prospective cohort study.

Язык: Английский

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Race, Ethnicity, and Gender Disparities in Acute Myocardial Infarction

Critical Care Clinics, Год журнала: 2024, Номер 40(4), С. 685 - 707

Опубликована: Июнь 6, 2024

Язык: Английский

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Spontaneous coronary artery dissection (SCAD) with cardiac arrest at presentation: A subanalysis from the DISCO registry

International Journal of Cardiology, Год журнала: 2024, Номер 412, С. 132331 - 132331

Опубликована: Июль 2, 2024

Язык: Английский

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Tratamiento médico del shock cardiogénico

Medicina Intensiva, Год журнала: 2024, Номер 48(8), С. 477 - 486

Опубликована: Июнь 22, 2024

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Management of non-Cardiac Organ Failure in cardiogenic shock

American Heart Journal Plus Cardiology Research and Practice, Год журнала: 2025, Номер 55, С. 100549 - 100549

Опубликована: Май 1, 2025

Cardiogenic shock (CS) is a syndrome of low cardiac output leading to systemic hypoperfusion. The mainstay management involves optimizing preload, afterload, and contractility restore central hemodynamics. However, CS frequently complicated by non-cardiac organ failure, for which there limited guidance. Herein, we review the pathophysiology, assessment, respiratory, renal, hepatic, neurological failure in context CS. This intended provide an evidence-based framework extracardiac sequelae patients medical intensive care unit.

Язык: Английский

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Effects of intra-aortic balloon pump on in-hospital outcomes and 1-year mortality in patients with acute myocardial infarction complicated by cardiogenic shock

BMC Cardiovascular Disorders, Год журнала: 2023, Номер 23(1)

Опубликована: Авг. 29, 2023

The role of intra-aortic balloon counterpulsation (IABP) in cardiogenic shock complicating acute myocardial infarction (AMI) is still a subject intense debate. In this study, we aim to investigate the effect IABP on clinical outcomes patients with AMI complicated by undergoing percutaneous coronary intervention (PCI).From Medical Information Mart for Intensive Care (MIMIC)-IV 2.2, 6017 were subtracted, and 250 PCI analyzed. In-hospital (death, 24-hour urine volumes, length ICU stays, hospital stays) 1-year mortality compared between control during course 12-month follow-up.An was implanted 30.8% (77/250) infarct-related PCI. had higher levels Troponin T (3.94 [0.73-11.85] ng/ml vs. 1.99 [0.55-5.75] ng/ml, p-value = 0.02). have longer stays (124 [63-212] hours 83 [43-163] hours, 0.005; [128-435] 170 [86-294] 0.009). use not associated lower in-hospital (33.8% 33.0%, 0.90) increased volumes (2100 [1455-3208] ml 1915 [1110-2815] ml, 0.25). addition, different group (48.1% 48.0%; hazard ratio 1.04, 95% CI 0.70-1.54, 0.851).IABP may be but better short-and long-term prognosis.

Язык: Английский

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