italian cardiogenic shock working group. group of physicians and other medical professional to...
TRANSCRIPT
![Page 1: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/1.jpg)
Italian Cardiogenic Shock Working Group
![Page 2: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/2.jpg)
Group of physicians and other medical professional to clarify the management of
Cardiogenic Shock in Italy
Condivision of Experience & Opinion
![Page 3: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/3.jpg)
No disclosure
Open & Spontaneous
1° Meeting Call: Milan, 2010 September
![Page 4: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/4.jpg)
Ospedale SS. Orsola, BolognaOspedale San Gerardo MonzaAzienda Ospedaliera di Padova PadovaOspedale S. Camillo RomaOspedali Civili Riuniti BresciaIstituto San Raffaele MilanoOspedale Careggi FirenzeOspedale Le Molinette TorinoOspedale Niguarda MilanoAzienda Ospedaliera di Chieti ChietiOspedale Santa Maria degli Angeli UdinePoliclinico Gemelli RomaISMET Palermo
![Page 5: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/5.jpg)
Ospedale SS. Orsola, BolognaOspedale San Gerardo MonzaAzienda Ospedaliera di Padova PadovaOspedale S. Camillo RomaOspedali Civili Riuniti BresciaIstituto San Raffaele MilanoOspedale Careggi FirenzeOspedale Le Molinette TorinoOspedale Niguarda MilanoAzienda Ospedaliera di Chieti ChietiOspedale S Maria degli Angeli UdinePoliclinico Gemelli RomaISMET PalermoAzienda Ospedaliera di Pisa PisaOspedale L. Sacco MilanoOspedale Monzino MonzaIstituto di Cura San Donato MilanoPoliclinico San Matteo PaviaOrganizzazione Emergenza 118 MilanoOspedale San Carlo MilanoAzienda Ospedaliera di Ravenna RavennaAzienda Ospedaliera di Verrona VeronaFICSICCHITACTA
![Page 6: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/6.jpg)
While the ‘definitive’ treatment of cardiogenic shock depends of the cause,
the initial management and assessment are essential to limit the damage due to global tissue hypoperfusion
![Page 7: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/7.jpg)
The key to good outcome in patients with cardiogenic shock
is an organized and multidisciplinary approach
Timing
![Page 8: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/8.jpg)
Epidemiology of Cardiogenic Shock in Italy
LomardIMA RegistryItalian ISS (SDO)GISEAMCO
Licterature
Cardiac Therapy Hub & Spoke Organizations
![Page 9: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/9.jpg)
Hub & Spoke Organization in Italy:
1. Level
2. Level: Cardiac Surgery Center
3. Level: Trasplant or VAD program Center
![Page 10: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/10.jpg)
![Page 11: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/11.jpg)
Aggressive approach to support the circulatory system in cardiogenic shock
with a extracorporeal life support is appropriate after
the failure of medical treatment and an IABP, when the cause is potentially reversible or
if the device can be used as a bridge option
![Page 12: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/12.jpg)
IndicationControindicationTimingManagement of ECLS/ECMO: Cannulation
Anticoagulation ProtocolComplications TreatmentComplications Prevention
EducationDefine the technical, surgical and medical expertise
![Page 13: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/13.jpg)
TREND ECMO 1986 - 2011
0
10
20
30
40
50
60
70
80
CARD PEDRESP PEDCARD ADRESP ADTOTALE
![Page 14: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/14.jpg)
TREND ECMO 2007 - 2011
0
10
20
30
40
50
60
70
80
2007 2008 2009 2010 2011
PAVIAMONZAS.CAMILLOFIRENZEPADOVAPALERMO
![Page 15: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/15.jpg)
0
102030
4050
6070
8090
100
PADOVA FIRENZE PAVIA MONZA PALERMOS.CAMILLO
PEDIATRICO
ADULTO
![Page 16: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/16.jpg)
VV - VA
0
10
20
3040
50
60
7080
90
100
PADOVA FIRENZE PAVIA MONZA PALERMO S.CAMILLO
VV
VA
![Page 17: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/17.jpg)
6 5,9
8,1
10,9
7
0
2
4
6
8
10
12
2007 2008 2009 2010 2011
MediaGiornateDegenzaECMO
![Page 18: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/18.jpg)
N° Transfert
0
5
10
15
20
25
30
35
PADOVA FIRENZE PAVIA MONZA PALERMO S.CAMILLO
ELIC
AMB
![Page 19: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/19.jpg)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
ECMO 2008
![Page 20: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/20.jpg)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
ECMO 2009
![Page 21: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/21.jpg)
123456789
10111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758
ECMO 2011
![Page 22: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/22.jpg)
Set Up ECMO circuit
FIRENZE PAVIA MONZA PALERMO PADOVA S.CAMILLO
WET NO NO NO DRY(WET)
NO
![Page 23: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/23.jpg)
FIRENZE PAVIA MONZA PALERMO PADOVA S.CAMILLO
6 hrs(TFCPC 7-20)
12 hrs 8hrs 6 hrs V-A(TFCPC h24)
24 hrs V-V
24 hrs 12 hrs
![Page 24: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/24.jpg)
Perfusionist Emergent/urgent
0
100
200
300
400
500
600
PADOVA FIRENZE PAVIA MONZA PALERMOS.CAMILLO
EMERGENTE
URGENTE
![Page 25: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/25.jpg)
URGENT
1,85/ ECMO
Emergent
1/18 ECMO
![Page 26: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/26.jpg)
Transfer Programm
![Page 27: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/27.jpg)
ECMO in Cath Lab
Acute Coronary Syndrome/PTCA
Ablation Procedure
TAVI procedure
![Page 28: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/28.jpg)
ECMO program
Free diffusion?
![Page 29: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/29.jpg)
Italian Cardiogenic Shock Working Group:
Position Paper for Cardiogenic Shock treatment
Use of ECMO in adult patients
Educational Program
![Page 31: Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision](https://reader036.vdocuments.us/reader036/viewer/2022062418/5542eb6a497959361e8d677e/html5/thumbnails/31.jpg)