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Published on: June 12, 2021
Survivorship After Cardiogenic Shock
Eric J Hall1,2, Sachin Agarwal3, C Munro Cullum4,5,6
1Division of Cardiology, Department of Internal Medicine (E.J.H., M.A.F.), University of Texas Southwestern Medical Center, Dallas.
Insights
Cardiogenic shock survivors show improved survival but face long-term challenges. Further research is needed to enhance recovery and quality of life for these patients.
Area of Science:
- Critical care medicine
- Cardiology
- Intensive care research
Background:
- Advances in critical care therapies have improved cardiogenic shock (CS) survival rates to 60-70%.
- CS survivors often experience long-term cardiac and extracardiac complications.
- Limited data exists on long-term recovery measures beyond hospital survival.
Purpose of the Study:
- To review unique aspects of cardiogenic shock survivorship.
- To highlight lessons from Post-Intensive Care Syndrome (PICS) in other critical illnesses.
- To outline future research directions for enhancing CS survivor recovery.
Main Methods:
- Literature review focusing on CS survivorship.
- Analysis of existing data on critical illness recovery.
- Identification of knowledge gaps in CS long-term outcomes.
Main Results:
- CS survivorship is improving, but long-term sequelae are significant.
- Post-Intensive Care Syndrome (PICS) impacts multiple domains (cognitive, physical, mental health) in critical illness survivors.
- CS survivorship shares commonalities with PICS but has unique challenges.
Conclusions:
- CS survivors require comprehensive long-term care strategies.
- Future research should focus on multidomain recovery and quality of life.
- Developing targeted interventions is crucial for improving outcomes after cardiogenic shock.
Abstract:
Advances in critical care therapies for patients with cardiogenic shock (CS), including temporary mechanical circulatory support and multidisciplinary shock teams, have led to improved survival to hospital discharge, ranging from 60% to 70%. After their index hospitalization, however, survivors of CS may continue to face cardiac as well as extracardiac sequelae of these therapies and complications for years to come. Most studies in CS have focused primarily on survival, with limited data on long-term recovery measures among survivors. In other forms of critical illness, research indicates that many intensive care unit survivors experience impairments in multiple domains, such as cognitive function, physical ability, and mental health. These impairments, collectively referred to as Post-Intensive Care Syndrome, in turn impact survivors' quality of life and future prognosis. This review identifies unique aspects of CS-related survivorship, highlights lessons learned from other forms of critical illness, and outlines future research directions to determine specific strategies to enhance recovery and survivorship after CS.
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