{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T14:40:38Z","timestamp":1781361638006,"version":"3.54.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>Outcomes for cardiogenic shock (CS) patients remain relatively poor despite significant advancements in primary percutaneous coronary interventions (PCI) and temporary circulatory support (TCS) technologies. Mortality from CS shows great disparities that seem to reflect large variations in access to care and physician practice patterns. Recent reports of different models to standardize care in CS have shown considerable potential at improving outcomes. The creation of regional, integrated, 3-tiered systems, would facilitate standardized interventions and equitable access to care. Multidisciplinary CS teams at Level I centers would direct care in a hub-and-spoke model through jointly developed protocols and real-time shared decision making. Levels II and III centers would provide early access to life-saving therapies and safe transfer to designated hub centers. In regions with large geographical distances, the implementation of telemedicine-cardiac intensive care unit (CICU) care can be an important resource for the creation of effective systems of care.<\/jats:p>","DOI":"10.3389\/fcvm.2021.712594","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T04:37:36Z","timestamp":1631767056000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Systems of Care in Cardiogenic Shock"],"prefix":"10.3389","volume":"8","author":[{"given":"Miguel","family":"Alvarez Villela","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preethi","family":"William","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B.","family":"Sims","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich P.","family":"Jorde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1016\/j.jacc.2019.01.053","article-title":"Acute noncardiac organ failure in acute myocardial infarction with cardiogenic shock","volume":"73","author":"Vallabhajosyula","year":"2019","journal-title":"J Am Coll Cardiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e232","DOI":"10.1161\/CIR.0000000000000525","article-title":"Contemporary management of cardiogenic shock: a scientific statement from the American Heart Association","volume":"136","author":"Van Diepen","year":"2017","journal-title":"Circulation."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e017326","DOI":"10.1161\/JAHA.120.017326","article-title":"Outcomes of hospitalizations for cardiogenic shock at left ventricular assist device versus non-left ventricular assist device centers","volume":"9","author":"Wang","year":"2020","journal-title":"J Am Heart Assoc."},{"key":"B4","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/j.amjcard.2019.05.038","article-title":"Hospital-level disparities in the outcomes of acute myocardial infarction with cardiogenic shock","volume":"124","author":"Vallabhajosyula","year":"2019","journal-title":"Am J Cardiol."},{"key":"B5","first-page":"371","article-title":"Cardiogenic shock management: international survey of contemporary practices","volume":"32","author":"Lobo","year":"2020","journal-title":"J Invasive Cardiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/j.jcin.2015.10.039","article-title":"Temporal trends and outcomes of patients undergoing percutaneous coronary interventions for cardiogenic shock in the setting of acute myocardial infarction: a report from the CathPCI registry","volume":"9","author":"Wayangankar","year":"2016","journal-title":"JACC Cardiovasc Interv."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1972","DOI":"10.1016\/j.jacc.2018.07.074","article-title":"Cardiac shock care centers: JACC review topic of the week","volume":"72","author":"Rab","year":"2018","journal-title":"J Am Coll Cardiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"e160","DOI":"10.2196\/resprot.9761","article-title":"Implementation of a cardiogenic shock team and clinical outcomes (INOVA-SHOCK Registry): observational and retrospective study","volume":"7","author":"Tehrani","year":"2018","journal-title":"JMIR Res Protoc."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e000590","DOI":"10.1161\/JAHA.113.000590","article-title":"Trends in incidence, management, and outcomes of cardiogenic shock complicating ST-elevation myocardial infarction in the United States","volume":"3","author":"Kolte","year":"2014","journal-title":"J Am Heart Assoc."},{"key":"B10","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.ijcard.2015.03.106","article-title":"17-year trends in incidence and prognosis of cardiogenic shock in patients with acute myocardial infarction in western Sweden","volume":"185","author":"Redfors","year":"2015","journal-title":"Int J Cardiol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1093\/eurheartj\/ehy004","article-title":"Impact of treatment delay on mortality in ST-segment elevation myocardial infarction (STEMI) patients presenting with and without haemodynamic instability: results from the German prospective, multicentre FITT-STEMI trial","volume":"39","author":"Scholz","year":"2018","journal-title":"Eur Heart J."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e000370","DOI":"10.1161\/JAHA.113.000370","article-title":"Growth in percutaneous coronary intervention capacity relative to population and disease prevalence","volume":"2","author":"Langabeer","year":"2013","journal-title":"J Am Heart Assoc."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e007099","DOI":"10.1161\/CIRCHEARTFAILURE.120.007099","article-title":"Invasive hemodynamic assessment and classification of in-hospital mortality risk among patients with cardiogenic shock","volume":"13","author":"Thayer","year":"2020","journal-title":"Circ Heart Fail."},{"key":"B14","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.rec.2020.03.010","article-title":"Initial outcomes of a multidisciplinary network for the care of patients with cardiogenic shock","volume":"74","author":"Hernandez-Perez","year":"2021","journal-title":"Rev Esp Cardiol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s00392-017-1182-2","article-title":"Trends in mechanical circulatory support use and hospital mortality among patients with acute myocardial infarction and non-infarction related cardiogenic shock in the United States","volume":"107","author":"Shah","year":"2018","journal-title":"Clin Res Cardiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e2037748","DOI":"10.1001\/jamanetworkopen.2020.37748","article-title":"Use of mechanical circulatory support devices among patients with acute myocardial infarction complicated by cardiogenic shock","volume":"4","author":"Dhruva","year":"2021","journal-title":"JAMA Netw Open."},{"key":"B17","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1016\/j.surg.2018.08.012","article-title":"Trends in mortality and resource utilization for extracorporeal membrane oxygenation in the United States: 2008-2014","volume":"165","author":"Sanaiha","year":"2019","journal-title":"Surgery."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1016\/S0735-1097(20)31952-5","article-title":"Disparities in the implantation of mechanical circulatory support for cardiogenic shock","volume":"75","author":"Thangam","year":"2020","journal-title":"J Am Coll Cardiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e006661","DOI":"10.1161\/CIRCHEARTFAILURE.119.006661","article-title":"Regional variation in the management and outcomes of acute myocardial infarction with cardiogenic shock in the United States","volume":"13","author":"Vallabhajosyula","year":"2020","journal-title":"Circ Heart Fail."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1016\/j.amjcard.2005.06.033","article-title":"Racial and ethnic differences in the treatment and outcome of cardiogenic shock following acute myocardial infarction","volume":"96","author":"Palmeri","year":"2005","journal-title":"Am J Cardiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e007154","DOI":"10.1161\/CIRCHEARTFAILURE.120.007154","article-title":"Sex Disparities in the management and outcomes of cardiogenic shock complicating acute myocardial infarction in the young","volume":"13","author":"Vallabhajosyula","year":"2020","journal-title":"Circ Heart Fail."},{"key":"B22","doi-asserted-by":"publisher","first-page":"3117","DOI":"10.3390\/jcm9103117","article-title":"Cardiogenic shock clinical presentation, management, and in-hospital outcomes in patients admitted to the acute cardiac care unit of a tertiary hospital: does gender play a role?","volume":"9","author":"Jer\u00f3nimo","year":"2020","journal-title":"J Clin Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ahj.2019.10.006","article-title":"Clinical and regulatory landscape for cardiogenic shock: a report from the Cardiac Safety Research Consortium ThinkTank on cardiogenic shock","volume":"219","author":"Samsky","year":"2020","journal-title":"Am Heart J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1002\/ccd.28329","article-title":"SCAI clinical expert consensus statement on the classification of cardiogenic shock","volume":"94","author":"Baran","year":"2019","journal-title":"Catheter Cardiovasc Intervent."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e020085","DOI":"10.1161\/JAHA.120.020085","article-title":"Phenotyping cardiogenic shock","volume":"2021","author":"Zweck","year":"2021","journal-title":"J Am Heart Assoc."},{"key":"B26","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1097\/MCC.0000000000000624","article-title":"An overview of international cardiogenic shock guidelines and application in clinical practice","volume":"25","author":"van Diepen","year":"2019","journal-title":"Curr Opin Crit Care."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e005618","DOI":"10.1161\/CIRCOUTCOMES.119.005618","article-title":"Epidemiology of shock in contemporary cardiac intensive care units","volume":"12","author":"Berg","year":"2019","journal-title":"Circ Cardiovasc Qual Outcomes."},{"key":"B28","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1253\/circj.CJ-16-0125","article-title":"Characteristics and predictors of mortality in patients with cardiovascular shock in Japan- results from the japanese circulation society cardiovascular shock registry","volume":"80","author":"Ueki","year":"2016","journal-title":"Circ J."},{"key":"B29","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1016\/j.cjco.2020.03.009","article-title":"Multidisciplinary code shock team in cardiogenic shock: a canadian centre experience","volume":"2","author":"Lee","year":"2020","journal-title":"CJC Open."},{"key":"B30","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1097\/SHK.0000000000001052","article-title":"Cardiogenic shock due to end-stage heart failure and acute myocardial infarction: characteristics and outcome of temporary mechanical circulatory support","volume":"50","author":"Lim","year":"2018","journal-title":"Shock."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.1016\/j.amjcard.2019.09.016","article-title":"Comparison of the hemodynamic response to intra-aortic balloon counterpulsation in patients with cardiogenic shock resulting from acute myocardial infarction versus acute decompensated heart failure","volume":"124","author":"Malick","year":"2019","journal-title":"Am J Cardiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"50","DOI":"10.14797\/mdcj-16-1-50","article-title":"Systems of care in cardiogenic shock","volume":"16","author":"Patarroyo Aponte","year":"2020","journal-title":"Methodist Debakey Cardiovasc J."},{"key":"B33","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1186\/s13054-020-03016-z","article-title":"Procedural volume and outcomes in patients undergoing VA-ECMO support","volume":"24","author":"Becher","year":"2020","journal-title":"Crit Care."},{"key":"B34","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1093\/eurheartj\/ehs081","article-title":"Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program)","volume":"34","author":"Beurtheret","year":"2013","journal-title":"Eur Heart J."},{"key":"B35","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1016\/j.healun.2010.11.018","article-title":"A traveling team concept to expedite the transfer and management of unstable patients in cardiopulmonary shock","volume":"30","author":"Jaroszewski","year":"2011","journal-title":"J Heart Lung Transplant."},{"key":"B36","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1016\/j.jacc.2019.01.039","article-title":"\u201cShock teams\u201d and \u201cshock docs\u201d","volume":"73","author":"Rab","year":"2019","journal-title":"J Am Coll Cardiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1002\/ccd.27427","article-title":"Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: the Detroit cardiogenic shock initiative","volume":"91","author":"Basir","year":"2018","journal-title":"Catheter Cardiovasc Interv."},{"key":"B38","article-title":"\u201cFinal results from the national cardiogenic shock initiative.\u201d Society of cardiovascular angiography and interventions scientific sessions.","author":"Basir","year":"2021"},{"key":"B39","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1161\/CIRCULATIONAHA.119.040654","article-title":"Shock team approach in refractory cardiogenic shock requiring short-term mechanical circulatory support: a proof of concept","volume":"140","author":"Taleb","year":"2019","journal-title":"Circulation."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1016\/j.jacc.2018.12.084","article-title":"Standardized team-based care for cardiogenic shock","volume":"73","author":"Tehrani","year":"2019","journal-title":"J Am Coll Cardiol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1002\/ccd.26297","article-title":"A team-based approach to patients in cardiogenic shock","volume":"88","author":"Doll","year":"2016","journal-title":"Catheter Cardiovasc Interv."},{"key":"B42","doi-asserted-by":"publisher","first-page":"81","DOI":"10.15420\/icr.2017:35:3","article-title":"'Combat' approach to cardiogenic shock","volume":"13","author":"Truesdell","year":"2018","journal-title":"Interv Cardiol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1177\/2048004019836365","article-title":"False activation of the cardiac catheterization laboratory for primary PCI","volume":"19","author":"Barnes","year":"2013","journal-title":"Am J Manag Care."},{"key":"B44","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1378\/chest.13-1973","article-title":"A multicenter study of ICU telemedicine reengineering of adult critical care","volume":"145","author":"Lilly","year":"2014","journal-title":"Chest."}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.712594\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T14:24:00Z","timestamp":1632147840000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.712594\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,16]]},"references-count":44,"alternative-id":["10.3389\/fcvm.2021.712594"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.712594","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,16]]},"article-number":"712594"}}