TY - JOUR
T1 - A Standardized and Comprehensive Approach to the Management of Cardiogenic Shock
AU - Tehrani, Behnam N.
AU - Truesdell, Alexander G.
AU - Psotka, Mitchell A.
AU - Rosner, Carolyn
AU - Singh, Ramesh
AU - Sinha, Shashank S.
AU - Damluji, Abdulla A.
AU - Batchelor, Wayne B.
N1 - Funding Information:
Dr. Tehrani has received consulting and speaker honoraria from Medtronic. Dr. Truesdell has received consulting and speaker honoraria from Abiomed. Dr. Damluji was supported by research funding from the Pepper Scholars Program of the Johns Hopkins University Claude D. Pepper Older Americans Independence Center, funded by the National Institute on Aging P30-AG021334. Dr. Batchelor has served as consultant for Boston Scientific, Abbott, Medtronic, and V-Wave. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Funding Information:
The authors thank the Dudley family for their continued contributions and support of the Inova Dudley Family Center for Cardiovascular Innovation. The authors also acknowledge Dr. Daniel Burkhoff and his team for the supplemental figure. Graphic design support was provided by Ms. Devon Stuart and Ms. Marie Dauenheimer under the guidance and direction of the authors.
Publisher Copyright:
© 2020 American College of Cardiology Foundation
PY - 2020/11
Y1 - 2020/11
N2 - Cardiogenic shock is a hemodynamically complex syndrome characterized by a low cardiac output that often culminates in multiorgan system failure and death. Despite recent advances, clinical outcomes remain poor, with mortality rates exceeding 40%. In the absence of adequately powered randomized controlled trials to guide therapy, best practices for shock management remain nonuniform. Emerging data from North American registries, however, support the use of standardized protocols focused on rapid diagnosis, early intervention, ongoing hemodynamic assessment, and multidisciplinary longitudinal care. In this review, the authors examine the pathophysiology and phenotypes of cardiogenic shock, benefits and limitations of current therapies, and they propose a standardized and team-based treatment algorithm. Lastly, they discuss future research opportunities to address current gaps in clinical knowledge.
AB - Cardiogenic shock is a hemodynamically complex syndrome characterized by a low cardiac output that often culminates in multiorgan system failure and death. Despite recent advances, clinical outcomes remain poor, with mortality rates exceeding 40%. In the absence of adequately powered randomized controlled trials to guide therapy, best practices for shock management remain nonuniform. Emerging data from North American registries, however, support the use of standardized protocols focused on rapid diagnosis, early intervention, ongoing hemodynamic assessment, and multidisciplinary longitudinal care. In this review, the authors examine the pathophysiology and phenotypes of cardiogenic shock, benefits and limitations of current therapies, and they propose a standardized and team-based treatment algorithm. Lastly, they discuss future research opportunities to address current gaps in clinical knowledge.
KW - acute decompensated heart failure
KW - acute myocardial infarction
KW - cardiogenic shock
KW - mechanical circulatory support
KW - multidisciplinary care
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U2 - 10.1016/j.jchf.2020.09.005
DO - 10.1016/j.jchf.2020.09.005
M3 - Review article
C2 - 33121700
AN - SCOPUS:85093662850
SN - 2213-1779
VL - 8
SP - 879
EP - 891
JO - JACC: Heart Failure
JF - JACC: Heart Failure
IS - 11
ER -