Standardized Team-Based Care for Cardiogenic Shock

Tehrani, Behnam; Truesdell, Alexander G.; Sherwood, Matthew W.; Desai, Shashank; Tran, Henry A.; Epps, Kelly; Singh, Ramesh; Psotka, Mitchell A.; Shah, Palak; Cooper, Lauren B.; Rosner, Carolyn; Raja, Anika; Barnett, Scott D.; Saulino, Patricia; deFilippi, Christopher R.; Gurbel, Paul A.; Murphy, Charles E.; O’Connor, Christopher M.

doi:10.1016/j.jacc.2018.12.084

Cited by 355 publications

(362 citation statements)

References 38 publications

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“…One such derived haemodynamic parameter is the pulmonary artery pulsatility index (PAPi), which is the ratio of pulmonary artery pulse pressure (PAPP) to right atrial pressure (RAP). The PAPi has been adopted into clinical practice, and was a central parameter in the algorithm described by Tehrani et al 2 in the management of cardiogenic shock. However, although the calculation for PAPi is simple, the physiological interpretation is more nuanced.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary artery pulsatility index: physiological basis and clinical application

Lim

Gustafsson

2019

European J of Heart Fail

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Pulmonary artery pulsatility index (PAPi) is a haemodynamic parameter that is derived from right atrial and pulmonary artery pulse pressures. A number of reports have described the prognostic value of PAPi in patients with advanced heart failure and cardiogenic shock. However, the derivation and physiological interpretation of this parameter have received little attention. This review will examine the physiological interpretation and clinical data for PAPi.

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Section: Introductionmentioning

confidence: 99%

Pulmonary artery pulsatility index: physiological basis and clinical application

Lim

Gustafsson

2019

European J of Heart Fail

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“…Nonetheless, these data highlight the importance of integrating OHCA and CS care pathways, as well as the early use of MCS devices to unload the left ventricle . Indeed, recent observational studies have shown significant improvements in in‐hospital and 30‐day survival to >70% with a standardized team‐based approach to management of AMICS . Helgestad et al .…”

Section: Temporal Trends In Incidence Revascularization and Mortalimentioning

confidence: 99%

“…The increasing proportion of CS patients with NSTEMI, OHCA, and LVEF ≤30% are important findings and may explain at least to some extent the persistently high and unchanged mortality rates in this patient population despite improvements in revascularization rates and time from symptom onset to revascularization in the overall AMICS population and in those with STEMI and CS. Improving revascularization rates and time to revascularization in patients with NSTEMI and CS, developing ‘Shock Centers’ and ‘Shock Teams’ that integrate OHCA and CS care pathways, and early use of MCS prior to PCI may represent some of the areas of focus in the future to improve outcomes of patients with AMICS …”

Section: Temporal Trends In Incidence Revascularization and Mortalimentioning

confidence: 99%

“…17 Indeed, recent observational studies have shown significant improvements in in-hospital and 30-day survival to >70% with a standardized team-based approach to management of AMICS. 18,19 Helgestad et al 15 observed a decreasing use of IABP and a concomitant increase in the use of Impella and VA-ECMO, particularly after publication of the IABP-SHOCK II trial in 2012. 12 Although there are some observational data suggesting improved outcomes with Impella, especially when used before PCI, and with VA-ECMO with left ventricular unloading, randomized clinical trial data are lacking.…”

mentioning

confidence: 99%

“…Improving revascularization rates and time to revascularization in patients with NSTEMI and CS, developing 'Shock Centers' and 'Shock Teams' that integrate OHCA and CS care pathways, and early use of MCS prior to PCI may represent some of the areas of focus in the future to improve outcomes of patients with AMICS. 17,19 Conflict of interest: none declared.…”

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confidence: 99%

See 2 more Smart Citations

The changing face of cardiogenic shock complicating acute myocardial infarction

Kolte

2019

European J of Heart Fail

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Cardiogenic Shock After Acute Myocardial Infarction

Samsky

Morrow

Proudfoot

et al. 2021

JAMA

179

101

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ardiogenic shock (CS) is defined by systemic hypoperfusion and tissue hypoxia due to cardiac dysfunction. The most common etiology of CS is acute myocardial ischemia due to occlusion of an epicardial coronary artery, resulting in regional cardiac myocyte necrosis (acute myocardial infarction [AMI]) and loss of ventricular function. 1 CS is the leading cause of in-hospital death in patients with AMI. Between 40 000 and 50 000 patients in the US have CS associated with AMI each year, which correlates to an incidence of approximately 5% to 10% of all patients with AMI. [2][3][4][5] Thirty-day mortality is nearly 40% and approaches approximately 50% at 1 year (Box). [5][6][7][8] Severe left ventricular (LV) dysfunction is the most common presentation of CS in the setting of AMI, most frequently occurring after anterior MI. Of the 686 patients included in the Percutaneous Coronary Intervention Strategies with Acute Myocardial Infarction and Cardiogenic Shock (CULPRIT-SHOCK) trial, 288 (42.0%) had a left anterior descending MI and 53 (7.7%) had a left main coronary artery MI. 7 Few treatment approaches reduce short-or long-term morbidity and mortality in patients with CS. This review describes the pathophysiology, diagnosis, and management of CS in the setting of AMI. MethodsA literature search was performed that applied the Cochrane Highly Sensitive Search Strategy for randomized clinical trials (RCTs), a string for meta-analyses and systematic reviews, and established Medical Subject Headings for "cardiogenic shock" and "treatment" to the PubMed and Cochrane databases for articles published from January 1, 1995, through August 5, 2021. The literature search identified 1552 articles. The authors prioritized RCTs, meta-analyses, and larger observational studies. A total of 46 papers were included, including 12 randomized trials, 2 metaanalyses, 1 systematic review, and 31 observational studies.

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Standardized Team-Based Care for Cardiogenic Shock

Cited by 355 publications

References 38 publications

Pulmonary artery pulsatility index: physiological basis and clinical application

Pulmonary artery pulsatility index: physiological basis and clinical application

The changing face of cardiogenic shock complicating acute myocardial infarction

Cardiogenic Shock After Acute Myocardial Infarction

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