Initial outcomes of a multidisciplinary network for the care of patients with cardiogenic shock

被引:0
作者
Jose Hernandez-Perez, Francisco [1 ]
Manuel Alvarez-Avello, Jose [2 ]
Forteza, Alberto [3 ]
Gomez-Bueno, Manuel [1 ,4 ]
Gonzalez, Ana [2 ]
Lopez-Ibor, Jorge, V [1 ]
Silva-Melchor, Lorenzo [1 ]
Goicolea, Javier [1 ]
Esteban Martin, Carlos [3 ]
Iranzo, Reyes [2 ]
Goirigolzarri-Artaza, Josebe [1 ]
Manuel Escudier-Villa, Juan [1 ]
Ortega-Marcos, Javier [1 ]
Francisco Oteo-Dominguez, Juan [1 ]
Herrero-Cano, Angela [2 ]
Monivas, Vanessa [1 ]
Mingo-Santos, Susana [1 ]
Villar, Susana [3 ]
Jimenez-Blanco, Marta [1 ]
Coscia, Claudia [1 ]
Serrano-Fiz, Santiago [3 ]
Alonso-Pulpon, Luis [1 ,4 ]
Segovia-Cubero, Javier [1 ,4 ]
机构
[1] Hosp Univ Puerta Hierro, Serv Cardiol, Manuel de Falla 1, Madrid 28222, Spain
[2] Hosp Univ Puerta Hierro, Serv Anestesia & Reanimac, Madrid, Spain
[3] Hosp Univ Puerta Hierro, Serv Cirugia Cardiaca, Madrid, Spain
[4] Inst Carlos III, Ctr Invest Biomed Red Enfermedades Cardiovasc, Madrid, Spain
来源
REVISTA ESPANOLA DE CARDIOLOGIA | 2021年 / 74卷 / 01期
关键词
Cardiogenic shock; Mechanical circulatory support; Multidisciplinary team; Regional network for cardiogenic shock; MECHANICAL CIRCULATORY SUPPORT; EXTRACORPOREAL MEMBRANE-OXYGENATION; ACUTE MYOCARDIAL-INFARCTION; TRANSPLANTATION; MANAGEMENT;
D O I
10.1016/j.recesp.2020.01.019
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction and objectives: Mortality remains high in cardiogenic shock (CS), especially in refractory CS involving the use of mechanical circulatory support (MCS) devices. The aim of this study was to analyze the results of a care program for patients in CS after the creation of a multidisciplinary team in our center and a regional network of hospitals in our area. Methods: Observational and retrospective study of patients attended in this program from September 2014 to January 2019. We included patients in refractory CS who required MCS and those who, because of their age and absence of comorbidities, were candidates for advanced therapies. The primary endpoint was survival to discharge. Results: A total of 130 patients were included (69 local and 61 transferred patients). The mean age was 52 +/- 15 years (72% men). The most frequent causes of CS were acute decompensated heart failure (29%), acute myocardial infarction (26%), and postcardiotomy CS (25%). MCS was used in 105 patients (81%), mostly extracorporeal membrane oxygenation (58%). Survival to discharge was 57% (74 of 130 patients). The most frequent destinations were myocardial recovery and heart transplant. Independent predictors of in-hospital mortality were SAPS II score, lactate level, acute myocardial infarction etiology, and vasoactive-inotropic score. Conclusions: The creation of multidisciplinary teams for patients with mainly refractory CS and a regional network is feasible and allows survival to discharge in more than a half of attended patients with CS. (C) 2020 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.
引用
收藏
页码:33 / 43
页数:11
相关论文
共 18 条
[1]   Clinical outcomes of temporary mechanical circulatory support as a direct bridge to heart transplantation: a nationwide Spanish registry [J].
Barge-Caballero, Eduardo ;
Almenar-Bonet, Luis ;
Gonzalez-Vilchez, Francisco ;
Lambert-Rodriguez, Jose L. ;
Gonzalez-Costello, Jose ;
Segovia-Cubero, Javier ;
Castel-Lavilla, Maria A. ;
Delgado-Jimenez, Juan ;
Garrido-Bravo, Iris P. ;
Rangel-Sousa, Diego ;
Martinez-Selles, Manuel ;
De la Fuente-Galan, Luis ;
Rabago-Juan-Aracil, Gregorio ;
Sanz-Julve, Marisa ;
Hervas-Sotomayor, Daniela ;
Mirabet-Perez, Sonia ;
Muniz, Javier ;
Crespo-Leiro, Maria G. .
EUROPEAN JOURNAL OF HEART FAILURE, 2018, 20 (01) :178-186
[2]   Venoarterial Extracorporeal Membrane Oxygenation for Cardiopulmonary Support Insights From a German Registry [J].
Becher, Peter Moritz ;
Schrage, Benedikt ;
Sinning, Christoph R. ;
Schmack, Bastian ;
Fluschnik, Nina ;
Schwarzl, Michael ;
Waldeyer, Christoph ;
Lindner, Diana ;
Seiffert, Moritz ;
Neumann, Johannes T. ;
Bernhardt, Alexander M. ;
Zeymer, Uwe ;
Thiele, Holger ;
Reichenspurner, Hermann ;
Blankenberg, Stefan ;
Twerenbold, Raphael ;
Westermann, Dirk .
CIRCULATION, 2018, 138 (20) :2298-2300
[3]   Epidemiology of Shock in Contemporary Cardiac Intensive Care Units Data From the Critical Care Cardiology Trials Network Registry [J].
Berg, David D. ;
Bohula, Erin A. ;
van Diepen, Sean ;
Katz, Jason N. ;
Alviar, Carlos L. ;
Baird-Zars, Vivian M. ;
Barnett, Christopher F. ;
Barsness, Gregory W. ;
Burke, James A. ;
Cremer, Paul C. ;
Cruz, Jennifer ;
Daniels, Lori B. ;
DeFilippis, Andrew P. ;
Haleem, Affan ;
Hollenberg, Steven M. ;
Horowitz, James M. ;
Keller, Norma ;
Kontos, Michael C. ;
Lawler, Patrick R. ;
Menon, Venu ;
Metkus, Thomas S. ;
Ng, Jason ;
Orgel, Ryan ;
Overgaard, Christopher B. ;
Park, Jeong-Gun ;
Phreaner, Nicholas ;
Roswell, Robert O. ;
Schulman, Steven P. ;
Snell, R. Jeffrey ;
Solomon, Michael A. ;
Ternus, Bradley ;
Tymchak, Wayne ;
Vikram, Fnu ;
Morrow, David A. .
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2019, 12 (03)
[4]   Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program) [J].
Beurtheret, Sylvain ;
Mordant, Pierre ;
Paoletti, Xavier ;
Marijon, Eloi ;
Celermajer, David S. ;
Leger, Philippe ;
Pavie, Alain ;
Combes, Alain ;
Leprince, Pascal .
EUROPEAN HEART JOURNAL, 2013, 34 (02) :112-120
[5]   A Team-Based Approach to Patients in Cardiogenic Shock [J].
Doll, Jacob A. ;
Ohman, E. Magnus ;
Patel, Manesh R. ;
Milano, Carmelo A. ;
Rogers, Joseph G. ;
Wohns, David H. ;
Kapur, Navin K. ;
Rao, Sunil V. .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2016, 88 (03) :424-433
[6]   Management of patients with cardiogenic shock on temporary mechanical circulatory support: urgent transplantation or on to the next pump? [J].
Gustafsson, Finn .
EUROPEAN JOURNAL OF HEART FAILURE, 2018, 20 (01) :187-189
[7]   Clinical picture and risk prediction of short-term mortality in cardiogenic shock [J].
Harjola, Veli-Pekka ;
Lassus, Johan ;
Sionis, Alessandro ;
Kober, Lars ;
Tarvasmaki, Tuukka ;
Spinar, Jindrich ;
Parissis, John ;
Banaszewski, Marek ;
Silva-Cardoso, Jose ;
Carubelli, Valentina ;
Di Somma, Salvatore ;
Tolppanen, Heli ;
Zeymer, Uwe ;
Thiele, Holger ;
Nieminen, Markku S. ;
Mebazaa, Alexandre .
EUROPEAN JOURNAL OF HEART FAILURE, 2015, 17 (05) :501-509
[8]   Early revascularization in acute myocardial infarction complicated by cardiogenic shock [J].
Hochman, JS ;
Sleeper, LA ;
Webb, JG ;
Sanborn, TA ;
White, HD ;
Talley, JD ;
Buller, CE ;
Jacobs, AK ;
Slater, JN ;
Col, J ;
McKinlay, SM ;
LeJemtel, TH .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (09) :625-634
[9]  
Kellner P, 2013, MED KLIN-INTENSIVMED, V108, P666, DOI 10.1007/s00063-013-0234-2
[10]  
Na SJ, 2019, REV ESP CARDIOL, V72, P40, DOI [10.1016/j.recesp.2017.12.020, 10.1016/j.rec.2018.01.003]