Algorithms, Axillary Access, Escalation Therapy, Patient Management, AMI Cardiogenic Shock, Surgical Applications
Escalation of Support and Algorithms for Cardiogenic Shock
Mark Anderson, MD, FACS, joins Dan Raess, MD, FACC, FACS, to discuss improving outcomes for patients in cardiogenic shock through the early use of mechanical circulatory support and the development of a shock protocol with the heart team.
Dr. Anderson outlines Hackensack University Medical Center’s multi-disciplinary, heart team approach in treatment decision-making for patients in cardiogenic shock. Cardiac surgeons, interventional cardiologists, heart failure specialists, and intensivists join together to make up the heart team. The team’s immediate first steps are:
- Identifying shock
- Initiating the heart team discussion
- Working down the algorithm
Dr. Anderson also shares his experience developing an algorithm for cardiogenic shock and the important role of hemodynamic monitoring. Once a patient is on mechanical circulatory support, the team at Hackensack University Medical Center uses hemodynamic monitoring to measure cardiac power output, in addition to the values of wedge pressures, CVP, pulmonary artery pressures.
Additionally, Dr. Anderson shares his experience treating patients who need escalation of support. The Hackensack team uses an axillary insertion strategy for patients who need to be escalated to Impella 5.0® support, which can be helpful in making ambulation possible for patients.