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构建心源性休克反应团队:改善预后的关键考虑因素。

Building a cardiogenic shock response team: key considerations necessary to improve outcomes.

机构信息

The Leon H. Charney Division of Cardiovascular Medicine, New York University Grossman School of Medicine, NYU Langone Medical Center.

Bellevue Hospital Center, New York, New York, USA.

出版信息

Curr Opin Crit Care. 2024 Aug 1;30(4):354-361. doi: 10.1097/MCC.0000000000001177. Epub 2024 Jun 10.

Abstract

PURPOSE OF REVIEW

This review provides key information about cardiogenic shock (CS) teams, including published evidence and practical recommendations to create a CS team and program.

RECENT FINDINGS

CS is a complex disease process with a high in-hospital mortality rate ranging from 30% to 70% according to recent registries and randomized studies. The explanation for the elevated rates is likely multifactorial, including the various etiologies of cardiogenic shock as well as delays in recognition and deployment of appropriate therapies. Accordingly, the use of cardiogenic shock team has been implemented with the aim of improving outcomes in these patients. The CS team typically consists of members with critical care or cardiac critical care expertise, heart failure, cardiothoracic surgery, and interventional cardiology. A number of retrospective studies have now supported the benefits of a CS team, particularly in selecting the appropriate candidates for tailored mechanical circulatory support therapies and providing interventions in a timely manner, which have translated into improved outcomes.

SUMMARY

CS teams provides a platform for expedited recognition of CS and timely, standardized, and multidisciplinary discussions regarding appropriate management and care.

摘要

目的综述

本文提供了关于心原性休克(CS)团队的关键信息,包括创建 CS 团队和项目的相关循证医学证据和实用建议。

最近的发现

CS 是一种复杂的疾病过程,根据最近的登记研究和随机研究,院内死亡率高达 30%至 70%。死亡率升高的原因可能是多因素的,包括心原性休克的各种病因以及适当治疗的识别和实施延迟。因此,使用心原性休克团队的目的是改善这些患者的预后。CS 团队通常由具有重症监护或心脏重症监护专业知识、心力衰竭、心胸外科和介入心脏病学专业知识的成员组成。现在有许多回顾性研究支持 CS 团队的益处,尤其是在为量身定制的机械循环支持治疗选择合适的候选者以及及时提供干预方面,这转化为改善了预后。

总结

CS 团队为快速识别 CS 提供了一个平台,并就适当的管理和护理进行及时、标准化和多学科讨论。

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