The Multi-disciplinary Shock Team and its Effect on Outcomes in Cardiogenic Shock Patients at Northwestern Memorial Hospital

Cardiogenic shock (CS) remains a significant complication of acute myocardial infarction (AMI) and decompensated heart failure (ADHF) with a mortality approaching nearly 50%. No clear data exists on appropriate use and timing of initiation of therapies in the management of CS, particularly that of acute mechanical circulatory support (AMCS) i.e. non-durable mechanical devices (Impella, Tandem Heart, Intraaortic balloon pump) and extracorporeal membrane oxygenation (ECMO). Moreover, there is limited data on the development of multidisciplinary shock teams and their effectiveness. We propose the development of a multidisciplinary CS team with the ability to deploy a rapid and acute analysis and implementation of current state-of-the-art AMCS therapies to help improve outcomes in the management of CS. Furthermore, we aim to develop a CS algorithm to identify CS patients earlier in their clinical course to ameliorate the considerable morbidity and mortality burden of the disease. Finally, we will track outcomes to examine the effectiveness of the implementation of our CS team and system-wide diagnostic/management algorithms.