The management of heart failure cardiogenic shock : an international RAND appropriateness panel
Williams, Stefan (St Bartholomew's Hospital (Regne Unit))
Kalakoutas, Antonis (St Bartholomew's Hospital (Regne Unit))
Olusanya, Segun (St Bartholomew's Hospital (Regne Unit))
Schrage, Benedict (University Heart and Vascular Center Hamburg)
Tavazzi, Guido (Fondazione Policlinico San Matteo Hospital IRCCS)
Carnicelli, Anthony P. (Medical University of South Carolina)
Montero, Santiago (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vandenbriele, Christophe (UZ Leuven)
Luk, Adriana (University Health Network (Canadà))
Lim, Hoong Sern (University Hospitals Birmingham NHS Foundation Trust (Birmingham, Regne Unit))
Bhagra, Sai Kiran (Royal Papworth Hospital NHS Foundation Trust)
Ott, Sascha (German Heart Center Berlin)
Farrero, Marta (Hospital Clínic i Provincial de Barcelona)
Samsky, Marc D. (Yale University School of Medicine)
Kennedy, Jamie L.W. (Inova Heart and Vascular Institute (Canadà))
Sen, Sounok (Yale University School of Medicine)
Agrawal, Richa (Duke University Medical Center (Durham, Estats Units d'Amèrica))
Rampersad, Penelope (Cleveland Clinic Foundation)
Coniglio, Amanda (Duke University Medical Center (Durham, Estats Units d'Amèrica))
Pappalardo, Federico (Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo)
Barnett, Christopher (University of California San Francisco)
Proudfoot, Alastair G. (Queen Mary University of London)

Data:	2024
Resum:	Background: Observational data suggest that the subset of patients with heart failure related CS (HF-CS) now predominate critical care admissions for CS. There are no dedicated HF-CS randomised control trials completed to date which reliably inform clinical practice or clinical guidelines. We sought to identify aspects of HF-CS care where both consensus and uncertainty may exist to guide clinical practice and future clinical trial design, with a specific focus on HF-CS due to acute decompensated chronic HF. Methods: A 16-person multi-disciplinary panel comprising of international experts was assembled. A modified RAND/University of California, Los Angeles, appropriateness methodology was used. A survey comprising of 34 statements was completed. Participants anonymously rated the appropriateness of each statement on a scale of 1 to 9 (1-3 as inappropriate, 4-6 as uncertain and as 7-9 appropriate). Results: Of the 34 statements, 20 were rated as appropriate and 14 were rated as inappropriate. Uncertainty existed across all three domains: the initial assessment and management of HF-CS; escalation to temporary Mechanical Circulatory Support (tMCS); and weaning from tMCS in HF-CS. Significant disagreement between experts (deemed present when the disagreement index exceeded 1) was only identified when deliberating the utility of thoracic ultrasound in the immediate management of HF-CS. Conclusion: This study has highlighted several areas of practice where large-scale prospective registries and clinical trials in the HF-CS population are urgently needed to reliably inform clinical practice and the synthesis of future societal HF-CS guidelines. (Figure presented. ).
Nota:	S.O. reports speakers fees from Vygon, Medtronic, Sonosite, and GE healthcare. S.C.O. reports receipt of institutional research and study funds from Novartis Pharma GmbH, as well as institutional research, study and educational grants, speaker fees, advisory board fees and travel cost reimbursement from Abiomed. M.F. reports receipt of a travel grant from Abbott, speaking fees and collaborations from Novartis, Boehringer, Astra-Zeneca, Bayer, Orion Pharma, Vifor. The other authors report no conflicts.
Nota:	A.G.P. is funded by a Medical Research Council CARP Award [MR/W03011X/1] and the Barts Charity.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Critical care, Vol. 28 Núm. 1 (december 2024) , p. 105, ISSN 1466-609X

DOI: 10.1186/s13054-024-04884-5
PMID: 38566212

10 p, 1.6 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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