Implementation of a cardiogenic shock team in a tertiary academic center.

Autor:	Karamasis GV; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Polyzogopoulou E; Emergency Medicine Department, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Varlamos C; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Frantzeskaki F; Department of Critical Care Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Dragona VM; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Boultadakis A; Emergency Medicine Department, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Bistola V; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Fountoulaki K; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Pappas C; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Kolokathis F; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Pavlopoulos D; Department of Cardiac Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Toumpoulis IK; Department of Cardiac Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Kollias VD; Department of Cardiac Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Farmakis D; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Rallidis LS; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece., Angouras DC; Department of Cardiac Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Tsangaris I; Department of Critical Care Medicine, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Parissis JT; Emergency Medicine Department, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece., Filippatos G; Cardiology Department, National and Kapodistrian University of Athens Medical School, Attikon University Hospital, Athens, Greece. Electronic address: gfilippatos@gmail.com.
Jazyk:	angličtina
Zdroj:	Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese [Hellenic J Cardiol] 2024 Jul 02. Date of Electronic Publication: 2024 Jul 02.
DOI:	10.1016/j.hjc.2024.06.011
Abstrakt:	Objective: Observational studies have shown that the management of patients with cardiogenic shock (CS) by dedicated multidisciplinary teams improves clinical outcomes. Nevertheless, these studies reflect a specific organizational setting with most patients being transferred from referring hospitals, hospitalized in cardiac intensive care units (ICU), or treated with mechanical circulatory support (MCS) devices. The purpose of this study was to document the organization and outcomes of a CS team offering acute care in an all-comer population. Methods: A CS team was developed in a large academic tertiary institution. The team consisted of emergency care physicians, critical care cardiologists, interventional cardiologists, cardiac surgeons, ICU physicians, and heart failure specialists and was supported by a predefined operating protocol, a dedicated communication platform, and regular team meetings. Results: Over 12 months, 70 CS patients (69 ± 13 years old, 67% males) were included. Acute myocardial infarction (AMI-CS) was the most common cause (64%); 31% of the patients presented post-resuscitated cardiac arrest and 56% needed invasive mechanical ventilation (IMV). Coronary angiography was performed in 70% and 53% had percutaneous coronary intervention. MCS was used in 10% and 6% were referred for urgent cardiac surgery. The in-hospital mortality in our center was 40% with 39% of the patients dying within 24 h from presentation. Overall, 76% of the live patients were discharged home. Conclusion: Across an all-comer population, AMI was the most common cause of CS. A significant number of patients presented post-cardiac arrest, and the majority required IMV. Mortality was high with a significant number dying within hours of presentation. Competing Interests: Conflicts of interest Nothing to declare. (Copyright © 2024 Hellenic Society of Cardiology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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