Clinical criteria for Cardiogenic Shock :
1. Systolic blood pressure <90 mm Hg for ≥30 min (or vasopressors to maintain systolic blood pressure ≥90 mm Hg) and evidence of end-organ hypoperfusion.
2. Hemodynamic criteria were Fick cardiac index ≤1.8 l/min/m2 without vasopressors (or ≤2.2 l/min/m2 with vasopressors) and a pulmonary capillary wedge pressure ≥15 mm Hg.
3. Lactic acid levels were measured as surrogate markers of end-organperfusionatbaselineand24hafterimplementation of therapies. Patients with both AMI-CS and ADHF-CS were evaluated.
What we do as Cardiogenic Shock specialised Heart Team:
1. The shock team is activated through a 1-call “shock line” to gather on-call physicians from 4 different service lines (interventional cardiology, cardiovascular surgery, advanced heart failure, and critical care) for multidisciplinary consultation.
2. The interventional team proceed with emergent coronary angiography, comprehensive hemodynamic assessment, and peripheral vascular evaluation for large-bore MCS access. If needed immediadely Impella device is available for insertion and ongoing patient management.
3. Same process for shock team activation is followed for non-ACS patients presenting with CS.
4. After shock team activation, non-ACS patients were transferred to the cardiac intensive care unit or cardiac catheterization laboratory for emergent transthoracic echocardiography and RHC to guide multidisciplinary decision making regarding pharmacological therapies and percutaneous Impella device.
Address: Rajasthan Hospital
Opp. Jaipuria Hospital, Milap
Nagar, JLN Marg, Jaipur
PH no.: 0141-2720020
Email.id: info@rajasthanhospital.in
website: www.rajasthanhospital.in
