Survival In Shock Research Articles

Lactate Clearance Is Associated With Improved Survival in Cardiogenic Shock: A Systematic Review and Meta-Analysis of Prognostic Factor Studies

ObjectiveElevated blood lactate levels are strongly associated with mortality in patients with cardiogenic shock. Recent evidence suggests that the degree and rate at which blood lactate levels decrease after the initiation of treatment may be equally important in patient prognosis. We performed a systematic review and meta-analysis to evaluate the usefulness of lactate clearance as a prognostic factor in cardiogenic shock. Methods and ResultsWe performed searches of Ovid MEDLINE, Elsevier EMBASE, EBM Reviews–Cochrane Central Register of Controlled Trials, and Web of Science to identify studies comparing lactate clearance between survivors and nonsurvivors at one or more timepoints. Both prospective and retrospective studies were eligible for inclusion. Two study investigators independently screened, extracted data, and assessed the quality of all included studies. Twelve studies were included in the meta-analysis. The median lactate clearance at 6–8 hours was 21.9% (interquartile range [IQR] 14.6%–42.1%) in survivors and 0.6% (IQR –3.7% to 14.6%) in nonsurvivors. At 24 hours, the median lactate clearance was 60.7% (IQR 58.1%–76.3%) and 40.3% (IQR 30.2%–55.8%) in survivors and nonsurvivors, respectively. Accordingly, the pooled mean difference in lactate clearance between survivors and nonsurvivors at 6–8 hours was 17.3% (95% CI 11.6%–23.1%, P < .001) at 6–8 hours and 27.9% (95% CI 14.1%–41.7%, P < .001) at 24 hours. ConclusionsSurvivors had significantly greater lactate clearance at 6–8 hours and at 24 hours compared with nonsurvivors, suggesting that lactate clearance is an important prognostic marker in cardiogenic shock.

Elevated Plasma Bioactive Adrenomedullin and Mortality in Cardiogenic Shock: Results from the OptimaCC Trial.

Aims: Bioactive adrenomedullin (bio-ADM) was recently shown to be a prognostic marker in patients with acute circulatory failure. We investigate the association of bio-ADM with organ injury, functional impairment, and survival in cardiogenic shock (CS). Methods: OptimaCC was a multicenter and randomized trial in 57 patients with CS. In this post-hoc analysis, the primary endpoint was to assess the association between bio-ADM and 30-day all-cause mortality. Secondary endpoints included adverse events and parameters of organ injury or functional impairment. Results: Bio-ADM values were higher in 30-day non-survivors than 30-day survivors at inclusion (median (interquartile range) 67.0 (54.6–142.9) pg/mL vs. 38.7 (23.8–63.6) pg/mL, p = 0.010), at 24 h (p = 0.012), and up to 48 h (p = 0.027). Using a bio-ADM cutoff of 53.8 pg/mL, patients with increased bio-ADM had a HR of 3.90 (95% confidence interval 1.43–10.68, p = 0.008) for 30-day all-cause mortality, and similar results were observed even after adjustment for severity scores. Patients with the occurrence of refractory CS had higher bio-ADM value at inclusion (90.7 (59.9–147.7) pg/mL vs. 40.7 (23.0–64.7) pg/mL p = 0.005). Bio-ADM values at inclusion were correlated with pulmonary vascular resistance index, estimated glomerular filtration rate, and N-terminal pro-B-type natriuretic peptide (r = 0.49, r = –0.47, and r = 0.64, respectively; p < 0.001). Conclusions: In CS patients, the values of bio-ADM are associated with some parameters of organ injury and functional impairment and are prognostic for the occurrence of refractory CS and 30-day mortality.

DH Type II Radio Bursts During Solar Cycles 23 and 24: Frequency-Dependent Classification and Their Flare-CME Associations

We present the characteristics of DH type II bursts for the Solar Cycles 23 and 24. The bursts are classified according to their end frequencies into three categories, i.e. Low Frequency Group (LFG; 20 kHz $\leq$ $f$ $\leq$ 200 kHz), Medium Frequency Group (MFG; 200 kHz $<$ $f$ $\leq$ 1 MHz), and High Frequency Group (HFG; 1 MHz $<$ $f$ $\le$ 16 MHz). We find that the sources for LFG, MFG, and HFG events are homogeneously distributed over the active region belt. Our analysis shows a drastic reduction of the DH type II events during Solar Cycle 24 which includes only 35% of the total events (i.e. 179 out of 514). Despite having smaller number of DH type II events in the Solar Cycle 24, it contains a significantly higher fraction of LFG events compared to the previous cycle (32% $versus$ 24%). However, within the LFG group the cycle 23 exhibits significant dominance of type II bursts that extend below 50 kHz, suggesting rich population of powerful CMEs travelling beyond half of the Sun-Earth distance. The events of LFG group display strongest association with faster and wider (more than 82% events are halo) CMEs while at the source location they predominantly trigger large M/X class flares (in more than 83% cases). Our analysis also indicates that CME initial speed or flare energetics are partly related with the duration of type II burst and that survival of CME associated shock is determined by multiple factors/parameters related to CMEs, flares, and state of coronal and interplanetary medium. The profiles relating CME heights with respect to the end frequencies of DH type II bursts suggest that for HFG and MFG categories, the location for majority of CMEs ($\approx$65%-70%) is in well compliance with ten-fold Leblanc coronal density model, while for LFG events a lower value of density multiplier ($\approx$3) seems to be compatible.

Implications of ectomycorrhizal inoculation for drought stress tolerance of Atlas cedar (Cedrus atlantica (Endl.) Carrière) seedlings

Background: Ectomycorrhizal inoculation is a promising strategy to minimise the initial transplant shock and increase plant survival and growth during the first years of out-planting in the field. The aim of this research was to investigate the effect of sporal inoculum of three ectomycorrhizal fungi: Cortinarius cedretorum, Amanita vaginata and Inocybe geophylla on tolerance levels of Atlas cedar (Cedrus atlantica (Endl.) Carrière) seedlings subjected to applied drought stress in nursery conditions. Methods: Carpophores, seeds and organic forest soil were collected under pure stands of Atlas cedar. After fifteen months of growth, seedlings were subjected to drought stress by withholding water for thirty days; we assessed morphological and physiological variables of all seedling batches (inoculated and uninoculated, controlled and stressed seedlings) Results: All roots of inoculated stressed seedlings were mycorrhizal. The mycorrhization rates were 67%, 64.6% and 53.6% for stressed seedlings inoculated with Cortinarius cedretorum, Amanita vaginata, Inocybe geophylla, respectively. This root mycorrhization was accompanied by a significant improvement in seedling growth, especially height and length of the main root (10.2 cm, 52 cm) reached in stressed seedlings inoculated with Cortinarius cedretorum. There was a significant increase in relative water content, total chlorophyll, carotenoids, soluble sugars and starch, superoxide dismutase and ascorbate peroxydase enzyme activities in inoculated stressed seedlings compared with uninoculated seedlings. Conclusions: Inoculation of Atlas cedar seedlings with spores of ectomycorrhizal fungi remains a very effective alternative for improving growth and the morphological and physiological status of seedlings under drought conditions. Cortinarius cedretorum appears to be consistently advantageous followed by Amanita vaginata and Inocybe geophylla.

Axillary or Subclavian Impella 5.0 Support in Cardiogenic Shock: A Systematic Review and Meta-analysis

Summary data around survival and adverse events of cardiogenic shock (CS) patients supported with axillary or subclavian artery 5.0 Impella are presently unavailable. We performed a systematic search of studies reporting the outcomes of axillary or subclavian access 5.0 Impella for refractory CS in PubMed, EMBASE, and the Cochrane Library. The primary outcome was 30-day survival. Secondary outcomes included survival to next therapy and adverse events on support. Proportional meta-analysis was used to pool across studies. Of the 795 potential studies identified, 13 studies were included in the meta-analysis (n = 256 patients). The average age of patients across studies was 56 ± 5 years. Thirty-day survival for the overall cohort was 66% (95% CI: 59–73). Survival to the next therapy was 68% (95% CI: 60–76). The occurrence of adverse events over an average of 13 (95% CI: 12–14) days of support was the following: stroke 5.9%, hemolysis 27%, pump thrombosis 4.4%, limb ischemia 0.1%, major bleeding 5.4%, device malfunction 10.6%, exchange 6.6%, and infection 14%. In this systematic review and meta-analysis, we report survival and adverse event rates of axillary or subclavian access 5.0 Impella for CS. Such summary data can inform clinician decision-making.

Nomogram to predict survival outcome of patients with veno-arterial extracorporeal membrane oxygenation after refractory cardiogenic shock

ABSTRACT Objective : This study aims to develop a nomogram model to predict the survival of refractory cardiogenic shock (RCS) patients that received veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Methods A total of 235 and 209 RCS patients were supported with VA-ECMO from January 2018 to December 2019 in Guangdong Provincial People’s Hospital, and from January 2020 to December 2020 in four third-grade and class-A hospitals were a development cohort (DC) and validation cohort (VC), respectively. Finally, 137 and 98 patients were included in the DC and VC. Multivariate logistic regression analysis was used to identify variables, and only these independent risk factors were used to establish the nomogram model. The receiver operating characteristic curve (ROC), calibration plot, decision curve, and clinical impact curves were used to evaluate the nomogram’s discriminative ability, predictive accuracy, and clinical application value. Results Pre-ECMO cardiogenic arrest (pre-ECA), lactate (Lac), inotropic score (IS), and modified nutrition risk in the critically ill score (mNUTRIC score) were incorporated into the nomogram. This showed good discrimination in the DC, with an area under ROC (AUROC) and a 95% confidence interval (CI) of 0.959 (0.911–0.986). The AUROC (95% CI) of the VC was 0.928 (0.858–0.971). The calibration plots of the DC and VC presented good calibration results. The decision curve and clinical impact curve of the nomogram provided improved benefits for RCS patients. Conclusions This study established a prediction nomogram composed of pre-ECA, Lac, IS, and mNUTRIC scores that could help clinicians to predict the survival probability at hospital discharge precisely and rapidly for RCS patients that received VA-ECMO.

Extracorporeal Membrane Oxygenation for Septic Shock in Children.

Extracorporeal membrane oxygenation (ECMO) is a rescue treatment used in children and adults with reversible cardiorespiratory failure. The role of ECMO is not fully established in pediatric sepsis. In this retrospective single-center study, we aimed to investigate risk factors and survival in pediatric septic shock supported with peripheral cannulation ECMO. All patients aged 30 days to 18 years treated between 2007 and 2016 with ECMO for septic shock were included. Of 158 screened patients, 31 were enrolled in the study. The P/F ratio was 48 ± 22 mm Hg, b-lactate 8.5 ± 6.6 mmol/L, p-procalcitonin 214 (IQR 19-294) μg/L, and 2 (1-2) vasoactive drugs were infused. The number of organ failures were 3 (3-4). Ten patients were commenced on venovenous and 21 on venoarterial ECMO. Survival from ECMO was 71%, and 68% survived to hospital discharge. Hospital survival was 80% for venovenous ECMO and 62% in venoarterial support (p = 0.43). Factors associated with in-hospital mortality were high b-lactate (p = 0.015) and high creatinine (p = 0.019) at admission. Conversion between modalities was not a risk factor. Sixty percent were alive at long-term follow-up (median 6.5 years). Peripheral cannulation ECMO is feasible in pediatric septic shock. Treatment should be performed at high-volume ECMO centers experienced in sepsis, and central or peripheral type and ECMO modality according to center preference and patient's need.

Ventricular Fibrillation Recurrences in Successfully Shocked Out-of-Hospital Cardiac Arrests.

Background and Objectives: The prognostic impact of ventricular fibrillation (VF) recurrences after a successful shock in out-of-hospital cardiac arrest (OOHCA) is still poorly understood, and some evidence suggests a potential pro-arrhythmic effect of chest compressions in this setting. In the present analysis, we looked at the short-term and long-term prognosis of VF recurrences in OOHCA. And their potential association with chest compressions. Materials and Methods: The Progetto Vita, prospectively collecting data on all resuscitation efforts in the Piacenza province (Italy), was used for the present analysis. From the 461 OOHCAs found in a shockable rhythm, only those with optimal ECG tracings and good audio recordings (160) were assessed. Rhythms other than VF post-shock were analyzed five seconds after shock delivery and survival to hospital admission, hospital discharge, and long-term survival data over a 14-year follow-up were collected. Results: Population mean age was 64.4 ± 16.9 years, and 31.9% of all patients were female. Mean time to EMS arrival was 5.9 ± 4.5 min. Short- and long-term survival without neurological impairment were higher in patients without VF recurrence when compared to patients with VF recurrence, independently from the pre-induction rhythm (p < 0.001). After shock delivery, VF recurrence was higher when chest compressions were resumed early after discharge and more vigorously. Conclusions: VF recurrences after a shock could worsen short and long-term survival. The potential pro-arrhythmic effect of chest compressions should be factored in when considering the real risks and benefits of this procedure.

Laboratory diet influences cold tolerance in a genotype-dependent manner in Drosophila melanogaster

Cold stress can reduce insect fitness and is an important determinant of species distributions and responses to climate change. Cold tolerance is influenced by genotype and environmental conditions, with factors such as day length and temperature having a particularly strong influence. Recent studies also indicate that diet impacts cold tolerance, but it is unclear whether diet-mediated shifts in cold tolerance are consistent across distinct genotypes. The goal of this study was to determine the extent to which commonly used artificial diets influence cold tolerance in Drosophila melanogaster, and whether these effects are consistent across genetically distinct lines. Specifically, we tested the impact of different fly diets on 1) ability to survive cold stress, 2) critical thermal minimum (CTmin), and 3) the ability to maintain reproduction after cold stress. Experiments were conducted across six isogenic lines from the Drosophila Genetic Reference Panel, and these lines were reared on different fly diets. Cold shock survival, CTmin, and reproductive output pre- and post-cold exposure varied considerably across diet and genotype combinations, suggesting strong genotype by environment interactions shape nutritionally mediated changes in cold tolerance. For example, in some lines cold shock survival remained consistently high or low across diets, while in others cold shock survival ranged from 5% to 75% depending on diet. Ultimately, these results add to a growing literature that cold tolerance is shaped by complex interactions between genotype and environment and inform practical considerations when selecting a laboratory diet for thermal tolerance experiments in Drosophila.

The Range of Cardiogenic Shock Survival by Clinical Stage: Data From the Critical Care Cardiology Trials Network Registry.

Cardiogenic shock presents with variable severity. Categorizing cardiogenic shock into clinical stages may improve risk stratification and patient selection for therapies. We sought to determine whether a structured implementation of the 2019 Society for Cardiovascular Angiography and Interventions clinical cardiogenic shock staging criteria that is ascertainable in clinical registries discriminates mortality in a contemporary population with or at-risk for cardiogenic shock. We developed a pragmatic application of the Society for Cardiovascular Angiography and Interventions cardiogenic shock staging criteria-A (at-risk), B (beginning), C (classic cardiogenic shock), D (deteriorating), or E (extremis)-and examined outcomes by stage. The Critical Care Cardiology Trials Network is an investigator-initiated multicenter research collaboration coordinated by the TIMI Study Group (Boston, MA). Consecutive admissions with or at-risk for cardiogenic shock during two annual 2-month collection periods (2017-2019) were analyzed. Patients with or at-risk for cardiogenic shock. Of 8,240 CICU admissions reviewed, 1,991 (24%) had or were at-risk for cardiogenic shock. Distributions across the five stages were as follows: A: 33%; B: 7%; C: 16%; D: 23%; and E: 21%. Overall in-hospital mortality among patients with established cardiogenic shock was 39%; however, mortality varied from only 15.8% to 32.1% to 62.5% across stages C, D, and E (Cochran-Armitage ptrend < 0.0001). The Society for Cardiovascular Angiography and Interventions stages improved mortality prediction beyond the Sequential Organ Failure Assessment and Intra-Aortic Balloon Pumpin Cardiogenic Shock II scores. Although overall mortality in cardiogenic shock remains high, it varies considerably based on clinical stage, identifying stage C as relatively lower risk. We demonstrate a pragmatic adaptation of the Society for Cardiovascular Angiography and Interventions cardiogenic shock stages that effectively stratifies mortality risk and could be leveraged for future clinical research.

Survival in septic shock associated with thrombocytopenia

Survival in septic shock associated with thrombocytopenia

OLFM4 polymorphisms predict septic shock survival after major surgery.

Higher expression of olfactomedin-4 (OLFM4), a gene regulated by nuclear factor-kappa B (NF-κB), has been related to a higher risk of organ failure and death in patients with septic shock. We aimed to evaluate the association between OLFM4 single nucleotide polymorphisms (SNPs) and septic shock-related death in 175 patients who underwent major surgery, as well as its performance in predicting mortality. We carried out a retrospective study. A total of seven OLFM4 SNPs were genotyped by Agena Bioscience's MassARRAY platform. Statistical analysis was performed by Kaplan-Meier and Cox regression tests. The diagnostic performance for predicting septic shock-related death was evaluated by the area under the receiver-operating characteristic (AUROC) curve. Patients with rs17552047 A allele and rs1891944 TT genotype had higher survival than patients with rs17552047 G allele (P-value=.024) and patients with rs1891944 CC/CT genotype (P-value=.038). However, only rs17552047 was associated with a lower risk of death under an additive inheritance model (adjusted hazard ratio [aHR]=0.44, 95% CI=0.27-0.71). The multivariate model with the most significant clinical variables (lactate, chronic kidney disease, peritonitis, heart disease and elective surgery) showed an AUROC of 0.776 for predicting septic shock-related death. When we added the OLFM4 rs17552047 SNP to the previous model, the AUROC was 0.811 and was close to reaching significant differences with the previous model (P-value=.065). OLFM4 rs17552047 A allele predicts septic shock survival in patients who underwent major surgery. Furthermore, rs17552047, together with clinical variables, could be useful to predict the outcome of septic shock.

Septic shock better controlled with earlier administration of norepinephrine

A clinical decision report appraising Elbouhy MA, Soliman M, Gaber A, Taema KM, Abdel-Aziz A. Early use of norepinephrine improves survival in septic shock: earlier than early. Archives of Medical Research. 2019;50(6):325–332. https://doi.org/10.1016/j.arcmed.2019.10.003

A novel assay for drug screening that utilizes the heat shock response of Caenorhabditis elegans nematodes.

Biological organisms respond to environmental stressors by recruiting multiple cellular cascades that act to mitigate damage and ultimately enhance survival. This implies that compounds that interact with any of those pathways might improve organism's survival. Here, we report on an initial attempt to develop a drug screening assay based on the heat shock (HS) response of Caenorhabditis elegans nematodes. The protocol works by subjecting the worms to two HS conditions in the absence/presence of the test compounds. Post-heat shock survival is quantified manually or in semi-automatic manner by analyzing z-stack pictures. We blindly screened a cassette of 72 compounds in different developmental stages provided by Eli Lilly through their Open Innovation Drug Discovery program. The analysis indicated that, on average, therapeutically useful drugs increase survival to HS compared to compounds used in non-clinical settings. We developed a formalism that estimates the probability of a compound to enhance survival based on a comparison with a set of parameters calculated from a pool of 35 FDA-approved drugs. The method correctly identified the developmental stages of the Lilly compounds based on their relative abilities to enhance survival to the HS. Taken together these data provide proof of principle that an assay that measures the HS response of C. elegans can offer physiological and pharmacological insight in a cost- and time-efficient manner.

Survival and recurrence in cardiogenic shock depending on its etiology

Cardiogenic shock (CS) from all causes has shown a very high mortality rate. The trial's aim is to compare the surviving rate at one and six months as well as recurrences at six months in CS depending on its etiology. We retrospectively reviewed from December 2014 until May 2018 in a monocentric observational study, 290 patients’ files, hospitalized for CS. 264 were included and then split into two groups: ACS-related cardiogenic shock ( n = 108) versus cardiomyopathy related cardiogenic shock ( n = 156). Patients with another etiology for CS were excluded from the present study. The inclusion criteria were: adult patient, hospitalized for CS or developping one during hospitalization. The primary composite end-point: death (at 1 and 6 months) were accurately notified. Recurrence at 6 months was the secondary end-point. No significant difference was found between the two groups regarding the survival at one or six months. The survival rate at one month in the ACS was about 73.6% versus 65.6% in the cardiomyopathy group ( P = 0.187) whereas the survival rate at six months was 63.2% for the ACS versus 60% for cardiomyopathys ( P = 0.517). No significant difference was observed in this study when we compared the recurrence rate, with 16.2% in the cardiomyopathy group versus 14.6% in the ACS group ( P = 0.729). Secondary analysis found that coronary revascularization ( P = 0.010), transfusion ( P = 0.033), use of IV diuretics ( P < 0.001) were positive predictors of survival. The predictors of mortality (at 1 or 6 month) with univariate analysis were patients over 72 years old ( P = 0.006) or with low left ventricular ejection fraction < 35% ( P = 0.013), as well as the use of amins drugs > 5 days ( P = 0.011) or use of Epinephrine ( P = 0.004). This study shows no significant difference comparing survival at one and six months or re-hospitalization at six months whether CS happens with a known cardiomyopathy or during an acute coronary syndrome.

Differences in monocyte subsets are associated with short-term survival in patients with septic shock.

Sepsis is characterized by dynamic changes of the immune system resulting in deregulated inflammation and failure of homoeostasis and can escalate to septic shock. Circulating monocytes and other innate immune cells are among the first ones to recognize and clear pathogens. Monocytes have an important role in sepsis and septic shock and have been studied as potential diagnostic markers. In total, forty‐two patients with septic shock were recruited and blood samples obtained within first 12 hours of ICU admission. We showed that frequency of classical and intermediate monocytes assessed at the time of admission to the intensive care unit are significantly distinct in patients with septic shock who survived longer that five days from those who died. These parameters correlate significantly with differences in serum levels of inflammatory cytokines MCP‐1, IL‐6, IL‐8, IL‐10, and IL‐18, and with the proportion of helper and cytotoxic T cells. The described changes in frequency of monocyte subsets and their activation status may predict short‐term septic shock survival and help with fast identification of the group of vulnerable patients, who may profit from tailored therapy.

VA-ECMO improves survival in cardiogenic shock.

VA-ECMO improves survival in cardiogenic shock.

An outlook on biomarkers in cardiogenic shock.

Cardiogenic shock is a severe complication with mortality rates of ∼50% that requires a rapid and complex management to aid and identify the highest and lowest risk patients. To that end, novel cardiogenic shock biomarkers are needed to improve risk stratification and to personalize therapy. Established biomarkers such as BNP, NT-proBNP, ST2, and troponins provide insufficient predictive value in cardiogenic shock. More recent biomarkers, including DPP3, adrenomedullin, angiopoietin 2, and the CS4P score are gaining momentum. DPP3 showed early prediction of refractory status and survival in cardiogenic shock. The CS4P score is based on the levels of liver fatty acid-binding protein (L-FABP), beta-2-microglobulin (B2M), fructose-bisphosphate aldolase B (ALDOB), and SerpinG1 (IC1). These proteins are not cardiac-specific but reflect multiorgan dysfunction, systemic inflammation, and immune activation. The CS4P improved reclassification of 32% of patients compared with the CardShock risk score. A new wave of research focused on novel proteomic and molecular techniques, is providing new candidates that promise to aid clinical decision-making and patient stratification in cardiogenic shock. The CS4P score is emerging as the most robust, yet it requires prospective validation in cardiogenic shock patients managed with circulatory and ventricular assist devices.

Identification of conditionally essential genes for Streptococcus suis infection in pigs

ABSTRACT Streptococcus suis is a Gram-positive bacterium and zoonotic pathogen that causes meningitis and sepsis in pigs and humans. The aim of this study was to identify genes required for S. suis infection. We created Tn-Seq libraries in a virulent S. suis strain 10, which was used to inoculate pigs in an intrathecal experimental infection. Comparative analysis of the relative abundance of mutants recovered from different sites of infection (blood, cerebrospinal fluid, and meninges of the brain) identified 361 conditionally essential genes, i.e. required for infection, which is about 18% of the genome. The conditionally essential genes were primarily involved in metabolic and transport processes, regulation, ribosomal structure and biogenesis, transcription, and cell wall membrane and envelope biogenesis, stress defenses, and immune evasion. Directed mutants were created in a set of 10 genes of different genetic ontologies and their role was determined in ex vivo models. Mutants showed different levels of sensitivity to survival in whole blood, serum, cerebrospinal fluid, thermic shock, and stress conditions, as compared to the wild type. Additionally, the role of three selected mutants was validated in co-infection experiments in which pigs were infected with both wild type and isogenic mutant strains. The genetic determinants of infection identified in this work contribute to novel insights in S. suis pathogenesis and could serve as targets for novel vaccines or antimicrobial drugs.

MANAGEMENT AND OUTCOMES OF CARDIOGENIC SHOCK IN CARDIAC ICUS WITH AND WITHOUT SHOCK TEAMS: DATA FROM THE CRITICAL CARE CARDIOLOGY TRIALS NETWORK (CCCTN) REGISTRY

Single-center studies suggest that multi-disciplinary shock teams facilitating early use of invasive hemodynamics and mechanical circulatory support (MCS) devices are associated with better survival in cardiogenic shock (CS). The goal of this analysis was to characterize outcomes and practice