Related Experiment Video

Updated: May 14, 2026

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
07:39

Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock

Published on: August 16, 2021

Cardiogenic Shock Centers and Protocols for Acute Cardiovascular Care: Bridging the Gap Between Spoke and Hub Sites

Chirag Mehta1,2, Sahas Chandragiri3, Carl Atallah4

  • 1Department of Cardiology, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.

Cardiology and Therapy
|May 12, 2026
PubMed

Insights

Cardiogenic shock (CS) care can be improved at spoke sites with a generalizable approach. This review offers an algorithm for intrahospital escalation and stabilization strategies, regardless of multidisciplinary teams.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Health Systems Research

Background:

  • Cardiogenic shock (CS) presents significant inpatient morbidity and mortality.
  • The hub-and-spoke model promotes early transfer to specialized centers.
  • Current protocols are resource-intensive, limiting applicability at spoke sites and causing care inequities.

Purpose of the Study:

  • To provide a generalizable blueprint for cardiogenic shock management.
  • To develop an algorithm for intrahospital care escalation based on CS severity.
  • To offer stabilization and monitoring strategies independent of multidisciplinary teams.

Main Methods:

  • Literature review focusing on existing CS management protocols.
  • Development of a tiered algorithm for intrahospital care escalation.
  • Outline of essential stabilization and monitoring techniques for spoke sites.

Main Results:

  • A framework for a resource-independent CS management approach is proposed.
  • An algorithm stratifies care escalation based on patient acuity.
  • Practical stabilization and monitoring strategies are detailed for non-hub settings.

Conclusions:

  • A standardized, adaptable approach can improve cardiogenic shock outcomes at spoke sites.
  • Intrahospital escalation and monitoring protocols enhance care equity.
  • This review provides a practical guide for resource-limited settings.

Keywords:
Acute cardiovascular careCardiogenic shockProtocolsRegionalizationTeams

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