Cardiogenic shock teams and centres: a contemporary review of multidisciplinary care for cardiogenic shock
Cardiogenic shock (CS) portends high morbidity and mortality in the contemporary era. Despite advances in temporary mechanical circulatory supports (MCS), their routine use in CS to improve outcomes has not been established. Delays in diagnosis and timely delivery of care, disparities in accessing a...
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| Veröffentlicht in: | ESC Heart Failure Jg. 8; H. 2; S. 988 - 998 |
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| Hauptverfasser: | , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
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England
John Wiley & Sons, Inc
01.04.2021
John Wiley and Sons Inc Wiley |
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| ISSN: | 2055-5822, 2055-5822 |
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| Abstract | Cardiogenic shock (CS) portends high morbidity and mortality in the contemporary era. Despite advances in temporary mechanical circulatory supports (MCS), their routine use in CS to improve outcomes has not been established. Delays in diagnosis and timely delivery of care, disparities in accessing adjunct therapies such revascularization or MCS, and lack of a systematic approach to care of CS contribute to the poor outcomes observed in CS patients. There is growing interest for developing a standardized multidisciplinary team‐based approach in the management of CS. Recent prospective studies have shown feasibility of CS teams in improving survival across a spectrum of CS presentations. Herein, we will review the rationale for CS teams focusing on evidence supporting its use in streamlining care, optimizing revascularization strategies, and patient identification and MCS selection. The proposed structure and flow of CS teams will be outlined. An in‐depth analysis of four recent studies demonstrating improved outcomes with CS teams is presented. Finally, we will explore potential implementation hurdles and future directions in refining and widespread implementation of dedicated cross‐specialty CS teams. |
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| AbstractList | Cardiogenic shock (CS) portends high morbidity and mortality in the contemporary era. Despite advances in temporary mechanical circulatory supports (MCS), their routine use in CS to improve outcomes has not been established. Delays in diagnosis and timely delivery of care, disparities in accessing adjunct therapies such revascularization or MCS, and lack of a systematic approach to care of CS contribute to the poor outcomes observed in CS patients. There is growing interest for developing a standardized multidisciplinary team‐based approach in the management of CS. Recent prospective studies have shown feasibility of CS teams in improving survival across a spectrum of CS presentations. Herein, we will review the rationale for CS teams focusing on evidence supporting its use in streamlining care, optimizing revascularization strategies, and patient identification and MCS selection. The proposed structure and flow of CS teams will be outlined. An in‐depth analysis of four recent studies demonstrating improved outcomes with CS teams is presented. Finally, we will explore potential implementation hurdles and future directions in refining and widespread implementation of dedicated cross‐specialty CS teams. Abstract Cardiogenic shock (CS) portends high morbidity and mortality in the contemporary era. Despite advances in temporary mechanical circulatory supports (MCS), their routine use in CS to improve outcomes has not been established. Delays in diagnosis and timely delivery of care, disparities in accessing adjunct therapies such revascularization or MCS, and lack of a systematic approach to care of CS contribute to the poor outcomes observed in CS patients. There is growing interest for developing a standardized multidisciplinary team‐based approach in the management of CS. Recent prospective studies have shown feasibility of CS teams in improving survival across a spectrum of CS presentations. Herein, we will review the rationale for CS teams focusing on evidence supporting its use in streamlining care, optimizing revascularization strategies, and patient identification and MCS selection. The proposed structure and flow of CS teams will be outlined. An in‐depth analysis of four recent studies demonstrating improved outcomes with CS teams is presented. Finally, we will explore potential implementation hurdles and future directions in refining and widespread implementation of dedicated cross‐specialty CS teams. Cardiogenic shock (CS) portends high morbidity and mortality in the contemporary era. Despite advances in temporary mechanical circulatory supports (MCS), their routine use in CS to improve outcomes has not been established. Delays in diagnosis and timely delivery of care, disparities in accessing adjunct therapies such revascularization or MCS, and lack of a systematic approach to care of CS contribute to the poor outcomes observed in CS patients. There is growing interest for developing a standardized multidisciplinary team-based approach in the management of CS. Recent prospective studies have shown feasibility of CS teams in improving survival across a spectrum of CS presentations. Herein, we will review the rationale for CS teams focusing on evidence supporting its use in streamlining care, optimizing revascularization strategies, and patient identification and MCS selection. The proposed structure and flow of CS teams will be outlined. An in-depth analysis of four recent studies demonstrating improved outcomes with CS teams is presented. Finally, we will explore potential implementation hurdles and future directions in refining and widespread implementation of dedicated cross-specialty CS teams.Cardiogenic shock (CS) portends high morbidity and mortality in the contemporary era. Despite advances in temporary mechanical circulatory supports (MCS), their routine use in CS to improve outcomes has not been established. Delays in diagnosis and timely delivery of care, disparities in accessing adjunct therapies such revascularization or MCS, and lack of a systematic approach to care of CS contribute to the poor outcomes observed in CS patients. There is growing interest for developing a standardized multidisciplinary team-based approach in the management of CS. Recent prospective studies have shown feasibility of CS teams in improving survival across a spectrum of CS presentations. Herein, we will review the rationale for CS teams focusing on evidence supporting its use in streamlining care, optimizing revascularization strategies, and patient identification and MCS selection. The proposed structure and flow of CS teams will be outlined. An in-depth analysis of four recent studies demonstrating improved outcomes with CS teams is presented. Finally, we will explore potential implementation hurdles and future directions in refining and widespread implementation of dedicated cross-specialty CS teams. |
| Author | Moghaddam, Nima Lawler, Patrick R. So, Derek Fordyce, Christopher B. Diepen, Sean |
| AuthorAffiliation | 1 Division of Cardiology, Department of Medicine University of British Columbia Vancouver British Columbia Canada 2 Division of Cardiology University of Alberta Edmonton Alberta Canada 6 Interdepartmental Division of Critical Care Medicine University of Toronto Toronto Ontario Canada 3 University of Ottawa Heart Institute Ottawa Ontario Canada 4 Peter Munk Cardiac Centre University Health Network Toronto Ontario Canada 5 Ted Rogers Centre for Heart Research Toronto Ontario Canada |
| AuthorAffiliation_xml | – name: 5 Ted Rogers Centre for Heart Research Toronto Ontario Canada – name: 4 Peter Munk Cardiac Centre University Health Network Toronto Ontario Canada – name: 1 Division of Cardiology, Department of Medicine University of British Columbia Vancouver British Columbia Canada – name: 6 Interdepartmental Division of Critical Care Medicine University of Toronto Toronto Ontario Canada – name: 2 Division of Cardiology University of Alberta Edmonton Alberta Canada – name: 3 University of Ottawa Heart Institute Ottawa Ontario Canada |
| Author_xml | – sequence: 1 givenname: Nima orcidid: 0000-0003-0937-0641 surname: Moghaddam fullname: Moghaddam, Nima organization: University of British Columbia – sequence: 2 givenname: Sean surname: Diepen fullname: Diepen, Sean organization: University of Alberta – sequence: 3 givenname: Derek surname: So fullname: So, Derek organization: University of Ottawa Heart Institute – sequence: 4 givenname: Patrick R. surname: Lawler fullname: Lawler, Patrick R. organization: University of Toronto – sequence: 5 givenname: Christopher B. surname: Fordyce fullname: Fordyce, Christopher B. email: cfordyce@mail.ubc.ca organization: University of British Columbia |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33452763$$D View this record in MEDLINE/PubMed |
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| Copyright | 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. 2021. This work is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| Snippet | Cardiogenic shock (CS) portends high morbidity and mortality in the contemporary era. Despite advances in temporary mechanical circulatory supports (MCS),... Abstract Cardiogenic shock (CS) portends high morbidity and mortality in the contemporary era. Despite advances in temporary mechanical circulatory supports... |
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| StartPage | 988 |
| SubjectTerms | Cardiac catheterization Cardiogenic shock Cardiogenic shock centres Cardiogenic shock teams Clinical outcomes Critical care Extracorporeal membrane oxygenation Heart attacks Heart failure Hospitals Intubation Laboratories Medical imaging Medical referrals Mortality Patients Review Reviews Teams |
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| Title | Cardiogenic shock teams and centres: a contemporary review of multidisciplinary care for cardiogenic shock |
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