Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision.

Presentazione sul tema: "Italian Cardiogenic Shock Working Group. Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision."— Transcript della presentazione:

1 Italian Cardiogenic Shock Working Group

2 Group of physicians and other medical professional to clarify the management of Cardiogenic Shock in Italy Condivision of Experience & Opinion

3 No disclosure Open & Spontaneous 1° Meeting Call: Milan, 2010 September

4 Ospedale SS. Orsola, Bologna Ospedale San GerardoMonza Azienda Ospedaliera di PadovaPadova Ospedale S. CamilloRoma Ospedali Civili RiunitiBrescia Istituto San RaffaeleMilano Ospedale CareggiFirenze Ospedale Le MolinetteTorino Ospedale NiguardaMilano Azienda Ospedaliera di ChietiChieti Ospedale Santa Maria degli Angeli Udine Policlinico GemelliRoma ISMETPalermo

5 Ospedale SS. Orsola, Bologna Ospedale San GerardoMonza Azienda Ospedaliera di PadovaPadova Ospedale S. CamilloRoma Ospedali Civili RiunitiBrescia Istituto San RaffaeleMilano Ospedale CareggiFirenze Ospedale Le MolinetteTorino Ospedale NiguardaMilano Azienda Ospedaliera di ChietiChieti Ospedale S Maria degli Angeli Udine Policlinico GemelliRoma ISMETPalermo Azienda Ospedaliera di PisaPisa Ospedale L. SaccoMilano Ospedale MonzinoMonza Istituto di Cura San DonatoMilano Policlinico San MatteoPavia Organizzazione Emergenza 118Milano Ospedale San CarloMilano Azienda Ospedaliera di RavennaRavenna Azienda Ospedaliera di VerronaVerona FIC SICCH ITACTA

6 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

7 The key to good outcome in patients with cardiogenic shock is an organized and multidisciplinary approach Timing

8 Epidemiology of Cardiogenic Shock in Italy LomardIMA Registry Italian ISS (SDO) GISE AMCO Licterature Cardiac Therapy Hub & Spoke Organizations

9 Hub & Spoke Organization in Italy: 1. Level 2. Level: Cardiac Surgery Center 3. Level: Trasplant or VAD program Center

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11 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

12 Indication Controindication Timing Management of ECLS/ECMO: Cannulation Anticoagulation Protocol Complications Treatment Complications Prevention Education Define the technical, surgical and medical expertise

13 TREND ECMO 1986 - 2011

14 TREND ECMO 2007 - 2011

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16 VV - VA

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18 N° Transfert

19 ECMO 2008

20 ECMO 2009

21 ECMO 2011

22 Set Up ECMO circuit FIRENZEPAVIAMONZAPALERMOPADOVAS.CAMILLO WETNO DRY (WET) NO

23 FIRENZEPAVIAMONZAPALERMOPADOVAS.CAMILLO 6 hrs (TFCPC 7-20) 12 hrs8hrs6 hrs V-A (TFCPC h24) 24 hrs V-V 24 hrs12 hrs

24 Perfusionist Emergent/urgent

25 URGENT 1,85/ ECMO Emergent 1/ 18 ECMO

26 Transfer Programm

27 ECMO in Cath Lab Acute Coronary Syndrome/PTCA Ablation Procedure TAVI procedure

28 ECMO program Free diffusion?

29 Italian Cardiogenic Shock Working Group: Position Paper for Cardiogenic Shock treatment Use of ECMO in adult patients Educational Program

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