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Building a cardiogenic shock response team: key considerations necessary to improve outcomes
Bhavya Varma1, Jason N Katz1,2, Carlos L Alviar1,2
1The Leon H. Charney Division of Cardiovascular Medicine, New York University Grossman School of Medicine, NYU Langone Medical Center.
Insights
Establishing a dedicated cardiogenic shock (CS) team improves patient outcomes. These multidisciplinary teams facilitate rapid recognition and standardized care for complex CS cases, enhancing survival rates.
Area of Science:
- Cardiology
- Critical Care Medicine
- Health Systems Management
Background:
- Cardiogenic shock (CS) is a critical condition with high in-hospital mortality (30-70%).
- Multifactorial causes and treatment delays contribute to poor outcomes.
- Multidisciplinary CS teams are increasingly implemented to improve patient care.
Purpose of the Study:
- To review evidence and provide recommendations for establishing cardiogenic shock teams.
- To outline the composition and function of effective CS teams.
- To highlight the benefits of a structured approach to CS management.
Main Methods:
- Review of published literature on cardiogenic shock teams.
- Analysis of retrospective studies supporting the efficacy of CS teams.
- Synthesis of practical recommendations for team and program creation.
Main Results:
- CS teams enhance the selection of patients for mechanical circulatory support.
- Timely interventions and standardized care improve patient outcomes.
- Evidence from retrospective studies supports the benefits of CS teams.
Conclusions:
- CS teams offer a platform for rapid CS recognition.
- They enable timely, standardized, multidisciplinary decision-making.
- Implementation of CS teams is crucial for optimizing patient management and outcomes.
Purpose Of Review:
This review provides key information about cardiogenic shock (CS) teams, including published evidence and practical recommendations to create a CS team and program.
Recent Findings:
CS is a complex disease process with a high in-hospital mortality rate ranging from 30% to 70% according to recent registries and randomized studies. The explanation for the elevated rates is likely multifactorial, including the various etiologies of cardiogenic shock as well as delays in recognition and deployment of appropriate therapies. Accordingly, the use of cardiogenic shock team has been implemented with the aim of improving outcomes in these patients. The CS team typically consists of members with critical care or cardiac critical care expertise, heart failure, cardiothoracic surgery, and interventional cardiology. A number of retrospective studies have now supported the benefits of a CS team, particularly in selecting the appropriate candidates for tailored mechanical circulatory support therapies and providing interventions in a timely manner, which have translated into improved outcomes.
Summary:
CS teams provides a platform for expedited recognition of CS and timely, standardized, and multidisciplinary discussions regarding appropriate management and care.
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