{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T23:50:31Z","timestamp":1773445831899,"version":"3.50.1"},"reference-count":25,"publisher":"Texas Heart Institute Journal","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,1]]},"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Cardiogenic shock\u2013related mortality is substantial, and temporary mechanical circulatory support (MCS) devices are frequently used. The authors aimed to describe patient characteristics and outcomes in patients with worsening cardiogenic shock requiring escalation of temporary MCS devices.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Worsening cardiogenic shock was defined as persistent hypotension, increasing doses of vasopressors\/inotropes, worsening hypoperfusion, or worsening invasive hemo-dynamics. Escalation of temporary MCS devices was defined as adding or exchanging an existing MCS device. Variables were evaluated by logistic regression models and receiver operating characteristic curves.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>From July 1, 2016, to July 1, 2018, a total of 81 consecutive patients experienced worsening cardiogenic shock requiring temporary MCS escalation. The etiology of cardiogenic shock was heterogeneous (33.3% acute myocardial infarction and 61.7% decompen-sated heart failure). Younger age (&lt;62 years), lower body mass index (&lt;28.7 kg\/m<jats:sup>2<\/jats:sup>), lower preescalation lactate levels (&lt;3.1 mmol\/L), higher postescalation blood pressure (&gt;85 mm Hg), and lower postescalation lactate levels (&lt;2.9 mmol\/L) were associated with greater odds of survival. The presence of a pulmonary artery catheter at the time of escalation was associated with greater odds of survival (<jats:italic>P<\/jats:italic> = .05). Escalation of temporary MCS in Society for Cardiovascular Angiography and Interventions stage E shock was associated with 100% mortality (<jats:italic>P<\/jats:italic> = .05). The rate of overall survival to discharge was 32%.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Patients requiring temporary MCS escalation represent a high-risk cohort. Further work is needed to improve outcomes in this patient population.<\/jats:p>\n<\/jats:sec>","DOI":"10.14503\/thij-21-7615","type":"journal-article","created":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T18:04:04Z","timestamp":1671559444000},"source":"Crossref","is-referenced-by-count":3,"title":["Effects of Escalating Temporary Mechanical Circulatory Support in Patients With Worsening Cardiogenic Shock"],"prefix":"10.14503","volume":"49","author":[{"given":"Iyad N.","family":"Isseh","sequence":"first","affiliation":[{"name":"Inova Heart and Vascular Institute, Falls Church, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Gorgis","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carina","family":"Dagher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivani","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mir B.","family":"Basir","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin","family":"Parikh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Henry Ford Hospital, Detroit, Michigan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"5628","reference":[{"issue":"1","key":"i1526-6702-49-6-e217615-b1","series-title":"J Am Heart Assoc.","first-page":"e000590","article-title":"Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States","volume":"3","year":"2014","unstructured":"Kolte\nD,\n\n\nKhera\nS,\n\n\nAronow\nWS,\n\n\n.\nTrends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States.\nJ Am Heart Assoc.2014;3(1):e000590.\ndoi:10.1161\/JAHA.113.000590"},{"issue":"16","key":"i1526-6702-49-6-e217615-b2","series-title":"Circulation.","first-page":"e232","article-title":"Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association","volume":"136","year":"2017","unstructured":"van Diepen\nS,\n\n\nKatz\nJN,\n\n\nAlbert\nNM,\n\n\n.\nContemporary management of cardiogenic shock: a scientific statement from the American Heart Association.\nCirculation.2017;136(16):e232\u2013e268.\ndoi:10.1161\/CIR.0000000000000525"},{"issue":"20","key":"i1526-6702-49-6-e217615-b3","series-title":"Eur Heart J.","first-page":"1223","article-title":"Management of cardiogenic 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the classification of cardiogenic shock: This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019","volume":"94","year":"2019","unstructured":"Baran\nDA,\n\n\nGrines\nCL,\n\n\nBailey\nS,\n\n\n.\nSCAI clinical expert consensus statement on the classification of cardiogenic shock: This document was endorsed by the American College of Cardiology (ACC), the American Heart Association (AHA), the Society of Critical Care Medicine (SCCM), and the Society of Thoracic Surgeons (STS) in April 2019.\nCatheter Cardiovasc Interv.2019;94(1):29\u201337.\ndoi:10.1002\/ccd.28329"},{"issue":"7","key":"i1526-6702-49-6-e217615-b6","series-title":"Catheter Cardiovasc Interv.","first-page":"1173","article-title":"Improved outcomes associated with the use of shock protocols: updates from the National Cardiogenic Shock 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artery pulsatility index identifies severe right ventricular dysfunction in acute inferior myocardial infarction","volume":"80","year":"2012","unstructured":"Korabathina\nR,\n\n\nHeffernan\nKS,\n\n\nParuchuri\nV,\n\n\n.\nThe pulmonary artery pulsatility index identifies severe right ventricular dysfunction in acute inferior myocardial infarction.\nCatheter Cardiovasc Interv.2012;80(4):593\u2013600.\ndoi:10.1002\/ccd.23309"},{"issue":"11","key":"i1526-6702-49-6-e217615-b9","series-title":"Eur J Heart Fail.","first-page":"1370","article-title":"Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study","volume":"21","year":"2019","unstructured":"Helgestad\nOKL,\n\n\nJosiassen\nJ,\n\n\nHassager\nC,\n\n\n.\nTemporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study.\nEur J Heart Fail.2019;21(11):1370\u20131378.\ndoi:10.1002\/ejhf.1566"},{"issue":"14","key":"i1526-6702-49-6-e217615-b10","series-title":"J Am Coll Cardiol.","first-page":"1407","article-title":"National trends in the utilization of short-term mechanical circulatory support: incidence, outcomes, and cost analysis","volume":"64","year":"2014","unstructured":"Stretch\nR,\n\n\nSauer\nCM,\n\n\nYuh\nDD,\n\n\nBonde\nP.\n\n\nNational trends in the utilization of short-term mechanical circulatory support: incidence, outcomes, and cost analysis.\nJ Am Coll Cardiol.2014;64(14):1407\u20131415.\ndoi:10.1016\/j.jacc.2014.07.958"},{"issue":"14","key":"i1526-6702-49-6-e217615-b11","series-title":"J Am Coll Cardiol.","first-page":"1781","article-title":"Acute noncardiac organ failure in acute myocardial infarction with cardiogenic shock","volume":"73","year":"2019","unstructured":"Vallabhajosyula\nS,\n\n\nDunlay\nSM,\n\n\nPrasad\nA,\n\n\n.\nAcute noncardiac organ failure in acute myocardial infarction with cardiogenic shock.\nJ Am Coll Cardiol.2019;73(14):1781\u20131791.\ndoi:10.1016\/j.jacc.2019.01.053"},{"issue":"9","key":"i1526-6702-49-6-e217615-b12","series-title":"N Engl J Med.","first-page":"625","article-title":"Early revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. Should we emergently revascularize occluded coronaries for cardiogenic shock","volume":"341","year":"1999","unstructured":"Hochman\nJS,\n\n\nSleeper\nLA,\n\n\nWebb\nJG,\n\n\n.\nEarly revascularization in acute myocardial infarction complicated by cardiogenic shock. SHOCK Investigators. 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cardiogenic shock in the current era.\nJ Heart Lung Transplant.2013;32(1):106\u2013111.\ndoi:10.1016\/j.healun.2012.10.005"},{"issue":"25","key":"i1526-6702-49-6-e217615-b15","series-title":"N Engl J Med.","first-page":"2419","article-title":"PCI strategies in patients with acute myocardial infarction and cardiogenic shock","volume":"377","year":"2017","unstructured":"Thiele\nH,\n\n\nAkin\nI,\n\n\nSandri\nM,\n\n\n.\nPCI strategies in patients with acute myocardial infarction and cardiogenic shock.\nN Engl J Med.2017;377(25):2419\u20132432.\ndoi:10.1056\/NEJMoa1710261"},{"issue":"3","key":"i1526-6702-49-6-e217615-b16","series-title":"Circ Heart Fail.","first-page":"e005853","article-title":"Early escalation of mechanical circulatory support stabilizes and potentially rescues patients in refractory cardiogenic shock","volume":"13","year":"2020","unstructured":"Tongers\nJ,\n\n\nSieweke\nJT,\n\n\nKuhn\nC,\n\n\n.\nEarly escalation of mechanical circulatory support stabilizes and potentially rescues patients in refractory cardiogenic shock.\nCirc Heart Fail.2020;13(3):e005853.\ndoi:10.1161\/CIRCHEARTFAILURE.118.005853"},{"issue":"17","key":"i1526-6702-49-6-e217615-b17","series-title":"J Am Coll Cardiol.","first-page":"2117","article-title":"Cardiogenic shock classification to predict mortality in the cardiac intensive care unit","volume":"74","year":"2019","unstructured":"Jentzer\nJC,\n\n\nvan Diepen\nS,\n\n\nBarsness\nGW,\n\n\n.\nCardiogenic shock classification to predict mortality in the cardiac intensive care unit.\nJ Am Coll Cardiol.2019;74(17):2117\u20132128.\ndoi:10.1016\/j.jacc.2019.07.077"},{"issue":"3","key":"i1526-6702-49-6-e217615-b18","series-title":"Catheter Cardiovasc Interv.","first-page":"E213","article-title":"Application of the SCAI classification in a cohort of patients with cardiogenic shock","volume":"96","year":"2020","unstructured":"Schrage\nB,\n\n\nDabboura\nS,\n\n\nYan\nI,\n\n\n.\nApplication of the SCAI classification in a cohort of patients with cardiogenic shock.\nCatheter Cardiovasc Interv.2020;96(3):E213\u2013E219.\ndoi:10.1002\/ccd.28707"},{"issue":"14","key":"i1526-6702-49-6-e217615-b19","series-title":"Circulation.","first-page":"1184","article-title":"Value of hemodynamic monitoring in patients with cardiogenic shock undergoing mechanical circulatory support","volume":"141","year":"2020","unstructured":"Saxena\nA,\n\n\nGaran\nAR,\n\n\nKapur\nNK,\n\n\n.\nValue of hemodynamic monitoring in patients with cardiogenic shock undergoing mechanical circulatory support.\nCirculation.2020;141(14):1184\u20131197.\ndoi:10.1161\/CIRCULATIONAHA.119.043080"},{"issue":"5","key":"i1526-6702-49-6-e217615-b20","series-title":"J Card Fail.","first-page":"364","article-title":"Trends in utilization and outcomes of pulmonary artery catheterization in heart failure with and without cardiogenic shock","volume":"25","year":"2019","unstructured":"Hernandez\nGA,\n\n\nLemor\nA,\n\n\nBlumer\nV,\n\n\n.\nTrends in utilization and outcomes of pulmonary artery catheterization in heart failure with and without cardiogenic shock.\nJ Card Fail.2019;25(5):364\u2013371.\ndoi:10.1016\/j.cardfail.2019.03.004"},{"issue":"6","key":"i1526-6702-49-6-e217615-b21","series-title":"Am J Cardiol.","first-page":"845","article-title":"Effect of early initiation of mechanical circulatory support on survival in cardiogenic shock","volume":"119","year":"2017","unstructured":"Basir\nMB,\n\n\nSchreiber\nTL,\n\n\nGrines\nCL,\n\n\n.\nEffect of early initiation of mechanical circulatory support on survival in cardiogenic shock.\nAm J Cardiol.2017;119(6):845\u2013851.\ndoi:10.1016\/j.amjcard.2016.11.037"},{"issue":"2","key":"i1526-6702-49-6-e217615-b22","series-title":"Eur Heart J.","first-page":"112","article-title":"Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program)","volume":"34","year":"2013","unstructured":"Beurtheret\nS,\n\n\nMordant\nP,\n\n\nPaoletti\nX,\n\n\n.\nEmergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program).\nEur Heart J.2013;34(2):112\u2013120.\ndoi:10.1093\/eurheartj\/ehs081"},{"issue":"14","key":"i1526-6702-49-6-e217615-b23","series-title":"Arch Intern Med.","first-page":"1643","article-title":"Systemic inflammatory response syndrome after acute myocardial infarction complicated by cardiogenic shock","volume":"165","year":"2005","unstructured":"Kohsaka\nS,\n\n\nMenon\nV,\n\n\nLowe\nAM,\n\n\n.\nSystemic inflammatory response syndrome after acute myocardial infarction complicated by cardiogenic shock.\nArch Intern Med.2005;165(14):1643\u20131650.\ndoi:10.1001\/archinte.165.14.1643"},{"issue":"2","key":"i1526-6702-49-6-e217615-b24","series-title":"Ann Thorac Surg.","first-page":"610","article-title":"Complications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1,866 adult patients","volume":"97","year":"2014","unstructured":"Cheng\nR,\n\n\nHachamovitch\nR,\n\n\nKittleson\nM,\n\n\n.\nComplications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1,866 adult patients.\nAnn Thorac Surg.2014;97(2):610\u2013616.\ndoi:10.1016\/j.athoracsur.2013.09.008"},{"issue":"11","key":"i1526-6702-49-6-e217615-b25","series-title":"Artif Organs.","first-page":"940","article-title":"Distal limb perfusion: Achilles' heel in peripheral venoarterial extracorporeal membrane oxygenation","volume":"38","year":"2014","unstructured":"Mohite\nPN,\n\n\nFatullayev\nJ,\n\n\nMaunz\nO,\n\n\n.\nDistal limb perfusion: Achilles' heel in peripheral venoarterial extracorporeal membrane oxygenation.\nArtif Organs.2014;38(11):940\u2013944.\ndoi:10.1111\/aor.12314"}],"container-title":["Texas Heart Institute 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