Algorithms, AMI Cardiogenic Shock

Best Practice Protocols for Cardiogenic Shock Showing Improved Outcomes Within the WellStar System


Salvatore Mannino, DO, MA, FACC, FSCAI, director of the short-term mechanical circulatory support program at WellStar Health System joins Seth Bilazarian, MD to discuss how his team has implemented a cardiogenic shock protocol that has shown to improve patient outcomes. Part of the protocol includes the following best practices:

  • Safe femoral practices for large bore access
  • Pre-PCI hemodynamic support
  • Use of pulmonary artery (PA) catheters in all patients
  • Limiting and early weaning of pressors and inotropes
  • Early and contemporaneous multi-disciplinary collaboration
  • Impella® heart pumps at all PCI-capable hospitals
  • Regionalization of care
  • 24x7 cardiology critical care coverage

Initial results at WellStar show a 72% survival rate (n=28) when the cardiogenic shock algorithm and best practices were used. Finally, the hub and spoke model has played an important role in improving outcomes and standardizing patient care.



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