PMID- 32695976
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220415
IS  - 2589-790X (Electronic)
IS  - 2589-790X (Linking)
VI  - 2
IP  - 4
DP  - 2020 Jul
TI  - Multidisciplinary Code Shock Team in Cardiogenic Shock: A Canadian Centre 
      Experience.
PG  - 249-257
LID - 10.1016/j.cjco.2020.03.009 [doi]
AB  - BACKGROUND: Cardiogenic shock (CS) is associated with high mortality. We report 
      on a "Shock Team" approach of combined interdisciplinary expertise for decision 
      making, expedited assessment, and treatment. METHODS: We reviewed 100 patients 
      admitted in CS over 52 months. Patients managed under a Code Shock Team protocol 
      (n = 64, treatment) from 2016 to 2019 were compared with standard care (n = 36, 
      control) from 2015 to 2016. The cohort was predominantly male (78% treatment, 67% 
      control) with a median age of 55 years (interquartile range [IQR], 43-64) for 
      treatment vs 64 years (IQR, 48-69) for control (P = 0.01). New heart failure was 
      more common in the treatment group: 61% vs 36%, P = 0.02. Acute myocardial 
      infarction comprised 13% of patients in CS. There were no significant differences 
      between treatment and control in markers of clinical acuity, including median 
      left ventricular ejection fraction (18% vs 20%), prevalence of moderate-severe 
      right ventricular dysfunction (64% vs 56%), median peak serum lactate (5.3 vs 4.7 
      mmol/L), acute kidney injury (70% vs 75%), or acute liver injury (50% vs 31%). 
      Inotropes, dialysis, and invasive ventilation were required in 92%, 33%, and 66% 
      of patients, respectively. Temporary mechanical circulatory support was used in 
      45% of treatment and 28% of control patients (P = 0.08). There were no 
      significant differences in median hospital length of stay (17.5 days), 30-day 
      survival (71%), or survival to hospital discharge (66%). Over 240 days (IQR, 
      14,847) of median follow-up, survival was 67% for treatment vs 42% for control 
      (hazard ratio, 0.53; 95% confidence interval, 0.28-0.99; P = 0.03). CONCLUSION: A 
      multidisciplinary Code Shock Team approach for CS is feasible and may be 
      associated with improved long-term survival.
CI  - Crown Copyright (c) 2020 Published by Elsevier Inc. on behalf of the Canadian 
      Cardiovascular Society.
FAU - Lee, Felicity
AU  - Lee F
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Hutson, Jordan H
AU  - Hutson JH
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Boodhwani, Munir
AU  - Boodhwani M
AD  - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - McDonald, Bernard
AU  - McDonald B
AD  - Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - So, Derek
AU  - So D
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - De Roock, Sophie
AU  - De Roock S
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Rubens, Fraser
AU  - Rubens F
AD  - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - Stadnick, Ellamae
AU  - Stadnick E
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Ruel, Marc
AU  - Ruel M
AD  - Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, 
      Ontario, Canada.
FAU - Le May, Michel
AU  - Le May M
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Labinaz, Marino
AU  - Labinaz M
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Chien, Kevin
AU  - Chien K
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Garuba, Habibat A
AU  - Garuba HA
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Mielniczuk, Lisa M
AU  - Mielniczuk LM
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
FAU - Chih, Sharon
AU  - Chih S
AD  - Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, 
      Canada.
LA  - eng
PT  - Journal Article
DEP - 20200327
PL  - United States
TA  - CJC Open
JT  - CJC open
JID - 101763635
PMC - PMC7365831
EDAT- 2020/07/23 06:00
MHDA- 2020/07/23 06:01
PMCR- 2020/03/27
CRDT- 2020/07/23 06:00
PHST- 2020/02/07 00:00 [received]
PHST- 2020/03/19 00:00 [accepted]
PHST- 2020/07/23 06:00 [entrez]
PHST- 2020/07/23 06:00 [pubmed]
PHST- 2020/07/23 06:01 [medline]
PHST- 2020/03/27 00:00 [pmc-release]
AID - S2589-790X(20)30033-0 [pii]
AID - 10.1016/j.cjco.2020.03.009 [doi]
PST - epublish
SO  - CJC Open. 2020 Mar 27;2(4):249-257. doi: 10.1016/j.cjco.2020.03.009. eCollection 
      2020 Jul.