Journal article
Definitions of Cardiogenic Shock and Indications for Temporary Mechanical Circulatory Support: Joint Consensus Report of the PeriOperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society
The Annals of thoracic surgery, v 120(2), pp 202-212
01 Aug 2025
PMID: 40187589
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: The management of patients with cardiogenic shock (CS) is complex and resource intensive, particularly given the recent surge in temporary mechanical circulatory support (tMCS) devices. This document was created to establish an approach to the assessment of CS to provide early and targeted therapies, including tMCS. Methods: An interdisciplinary, international panel of experts, using a structured appraisal of the literature and a modified Delphi method, derived consensus regarding the assessment of CS based on pathophysiologic severity, etiology, and phenotypic clustering to guide escalation of care as well as identify those patients who might benefit from tMCS. Results: Key principles included early and continuous assessment for the evolution of shock severity to guide the escalation of care as well as establishment of the cause of CS to facilitate triage and assignment of initial therapies. Phenotypic clustering is complementary and aids in prognosis. tMCS provides the greatest benefit in CS for relief of congestion refractory to medical therapy, ideally when initiated before the development of organ injury. The use of tMCS should be preceded by an interdisciplinary discussion as part of the informed consent process to establish therapeutic goals, including exit strategies. Conclusions: Based on the available literature and expert consensus, there is an opportunity to further standardize the approach to CS, including characterization based on the severity of the shock state, etiology, and further enhancement by phenotyping. Monitoring, early triage, and timely escalation of care, including the targeted initiation of tMCS, can minimize organ injury and in-hospital mortality.
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Details
- Title
- Definitions of Cardiogenic Shock and Indications for Temporary Mechanical Circulatory Support: Joint Consensus Report of the PeriOperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society
- Creators
- Michael C. Grant - Johns Hopkins MedicineCharles Scott Brudney - University of ManitobaJaime Hernandez-Montfort - Baylor Scott & White HealthStephanie O. Ibekwe - Baylor College of MedicineAmanda Rea - Division of Cardiac Surgery, Department of Surgery, University of Maryland Saint Joseph Medical Center, Towson, Maryland, United StatesChristian Stoppe - Universitätsklinikum WürzburgAlexander Zarbock - University Hospital MünsterAndrew D. Shaw - Cleveland ClinicDaniel T. Engelman - Baystate HealthManreet K. Kanwar - Drexel University, Cardiology
- Publication Details
- The Annals of thoracic surgery, v 120(2), pp 202-212
- Publisher
- Elsevier
- Number of pages
- 11
- Grant note
- Mazankoswski Alberta Heart Institute Wake Forest University (http://data.elsevier.com/vocabulary/SciValFunders/100007154) Cardiac Society Kevin W. Lobdell Fresenius SE & Co KGaA Sanger Heart & Vascular Institute PeriOperative Quality Initiative University of Arizona (http://data.elsevier.com/vocabulary/SciValFunders/100007899) Maastricht Universitair Medisch Centrum (http://data.elsevier.com/vocabulary/SciValFunders/501100004528) Boston Scientific Corporation (http://data.elsevier.com/vocabulary/SciValFunders/100008497)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiology
- Web of Science ID
- WOS:001558490000001
- Scopus ID
- 2-s2.0-105003382940
- Other Identifier
- 991022047283004721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems
- Respiratory System
- Surgery