Blumer Vanessa, Hanff Thomas C, Gage Ann, Schrage Benedikt, Kanwar Manreet K
Inova Schar Heart and Vascular, Falls Church, VA (V.B.).
Division of Cardiology, University of Utah, Salt Lake City (T.C.H.).
Circ Heart Fail. 2025 May;18(5):e011630. doi: 10.1161/CIRCHEARTFAILURE.124.011630. Epub 2025 Mar 28.
Cardiogenic shock (CS) remains a significant challenge in cardiovascular medicine, characterized by substantial morbidity and mortality. Historically, patient outcomes in CS have been varied, highly dependent on the timeliness of interventions and the expertise available at treating centers. Emerging evidence indicates that structured, team-based approaches significantly improve survival rates and diminish complications linked to CS. However, several challenges for implementing a team-based approach persist, including optimizing team composition and resource distribution. This article delves into the evolution, current implementations, and future directions of CS teams, emphasizing their crucial role in enhancing patient outcomes. We advocate for the adoption of standardized protocols to ensure uniformity of care across institutions, highlighting the critical need for prompt recognition and management strategies that integrate invasive hemodynamic monitoring and early mechanical circulatory support. Looking ahead, we propose the extension of CS team models into regional networks, broadening their impact through education, telemedicine and collaborative protocols. We also emphasize the importance of continuous research and data sharing via national registries to refine CS team strategies and substantiate their effects on patient outcomes. Ultimately, this review highlights the imperative for ongoing innovation and standardization in CS team operations to improve care delivery and enhance survival rates in CS scenarios.
心源性休克（CS）仍然是心血管医学中的一项重大挑战，其特征是高发病率和高死亡率。从历史上看，CS患者的预后各不相同，高度依赖于干预措施的及时性以及治疗中心所具备的专业知识。新出现的证据表明，结构化的、基于团队的方法能显著提高生存率，并减少与CS相关的并发症。然而，实施基于团队的方法仍存在一些挑战，包括优化团队组成和资源分配。本文深入探讨了CS团队的发展历程、当前实施情况以及未来发展方向，强调了它们在改善患者预后方面的关键作用。我们主张采用标准化方案，以确保各机构之间护理的一致性，强调迫切需要将有创血流动力学监测和早期机械循环支持相结合的快速识别和管理策略。展望未来，我们建议将CS团队模式扩展到区域网络，通过教育、远程医疗和协作方案扩大其影响力。我们还强调通过国家登记处进行持续研究和数据共享的重要性，以完善CS团队策略并证实其对患者预后的影响。最终，本综述强调了CS团队运作中持续创新和标准化的必要性，以改善护理服务并提高CS情况下的生存率。
