Outcomes in CArdiogenic SHock Patients Treated by MEchanical Circulatory suppoRt devicE : Impact of Shock Team
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 250
- 试验地点
- 1
- 主要终点
- Vital status
研究概览
简要总结
In this before-after monocenter study, the authors teste the hypothesis that the implementation of a dedicated shock team could improve the outcome of patients with refractory cardiogenic shock assisted by mechanical circulatory support.
详细描述
Short Term Mechanical Circulatory Support (STMCS) are the last resort therapeutics when refractory cardiogenic shock occurs. Growing technical possibilities like impella make the right choice at the right time challenging. At Bordeaux University Hospital, we have gathered the main protagonists which are the surgeon, the interventional cardiologist,and the intensivist as a shock team in January 2013. From that time, diagnosis of refractory cardiogenic shock triggers a multidisciplinary meeting driven by a common algorithm. The objective of this study is to perform a before-after comparison between decision of STMCS for refractory cardiogenic shock without shock team from january 2007 to january 2013 and after implementation of the shock team from April 2013 to April 2019.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of cardiogenic shock
- •>1 sign of refractory cardiogenic shock : Dobutamine >10µg/kg/mn, epinephrine>0.25µg/kg/mn or Milrinone > 0.5µg/kg/mn ; ScvO2<55% ; pO2/FiO2<100
- •No major counter indication to short term mechanical circulatory support : SOFA score > 15, prolonged cardiac arrest, severe chronic disease, direct LVAD implantation or heart transplantation, counter indication for systemic anticoagulation
排除标准
- •Age < 18years
- •Post cardiotomy cardiogenic shock
- •Implantation of Impella 2.5 alone
- •Implantation of Intra Aortic Balloon Pump alone
结局指标
主要结局
Vital status
时间窗: One year after short term mechanical circulatory support initiation
Proportion of patients alive
次要结局
- Vital status(6 months after short term mechanical circulatory support initiation)
- Long term mechanical circulatory support(up to intensive care unit discharge, an average of 15 days)
- Heart transplantation(up to intensive care unit discharge, an average of 15 days)
- Weaning from short term mechanical circulatory support(up to seven days from weaning attempt)
- Stroke(through short term mechanical circulatory support weaning, an average of 6 days)
- Lenght of stay(up to one year)
- New renal replacement therapy(up to intensive care unit discharge, an average of 15 days)
- Limb ischaemia(through short term mechanical circulatory support weaning, an average of 6 days)
- Short term mechanical circulatory support duration(through short term mechanical circulatory support weaning, an average of 6 days)
- Severe haemorrage(through short term mechanical circulatory support weaning, an average of 6 days)
- Extra Corporeal Membrane Oxygenation circuit clotting(through short term mechanical circulatory support weaning, an average of 6 days)
- Sepsis(up to intensive care unit discharge, an average of 15 days)
研究者
Alexandre OUATTARA
MD, PhD
University Hospital, Bordeaux