SCAI clinical expert consensus statement on the classification of cardiogenic shock

Catheterization and Cardiovascular Interventions - Tập 94 Số 1 - Trang 29-37 - 2019
David A. Baran1, Cindy L. Grines2, Steven R. Bailey3, Daniel Burkhoff4, Shelley Hall5, Timothy D. Henry6, Steven M. Hollenberg7, Navin K. Kapur8, William W. O’Neill9, Joseph P. Ornato10, Kelly Stelling1, Holger Thiele11, Sean van Diepen12, Srihari S. Naidu13
1Sentara Heart Hospital, Division of Cardiology, Advanced Heart Failure Center and Eastern Virginia Medical School, Norfolk, Virginia
2Department of Cardiology, Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, New York
3Department of Internal Medicine, LSU Health School of Medicine, Shreveport, Louisiana
4Cardiovascular Research Foundation, New York City, New York
5Baylor University Medical Center, Dallas, Texas
6Lindner Research Center at the Christ Hospital, Cincinnati, Ohio
7Cooper University Hospital, Camden, New Jersey
8The Cardiovascular Center, Tufts Medical Center, Boston, Massachusetts
9Henry Ford Health System, Detroit, Michigan
10Virginia Commonwealth University Health System, Richmond, Virginia
11Heart Center Leipzig at University of Leipzig, Department of Internal Medicine/Cardiology, Leipzig, Germany
12Department of Critical Care Medicine and Division of Cardiology, University of Alberta, Edmonton, Canada
13Westchester Medical Center and New York Medical College, Valhalla, New York

Tóm tắt

AbstractBackgroundThe outcome of cardiogenic shock complicating myocardial infarction has not appreciably changed in the last 30 years despite the development of various percutaneous mechanical circulatory support options. It is clear that there are varying degrees of cardiogenic shock but there is no robust classification scheme to categorize this disease state.MethodsA multidisciplinary group of experts convened by the Society for Cardiovascular Angiography and Interventions was assembled to derive a proposed classification schema for cardiogenic shock. Representatives from cardiology (interventional, advanced heart failure, noninvasive), emergency medicine, critical care, and cardiac nursing all collaborated to develop the proposed schema.ResultsA system describing stages of cardiogenic shock from A to E was developed. Stage A is “at risk” for cardiogenic shock, stage B is “beginning” shock, stage C is “classic” cardiogenic shock, stage D is “deteriorating”, and E is “extremis”. The difference between stages B and C is the presence of hypoperfusion which is present in stages C and higher. Stage D implies that the initial set of interventions chosen have not restored stability and adequate perfusion despite at least 30 minutes of observation and stage E is the patient in extremis, highly unstable, often with cardiovascular collapse.ConclusionThis proposed classification system is simple, clinically applicable across the care spectrum from pre‐hospital providers to intensive care staff but will require future validation studies to assess its utility and potential prognostic implications.

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Catheterization and Cardiovascular Interventions

Tập 94 Số 1

29-37

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