Efficacy of Shock Team Implementation for Cardiogenic Shock: A Systematic Review

IntroductionCardiogenic shock (CS) is a critical cardiac condition characterized by low cardiac output leading to end-organ hypoperfusion and associated with high in-hospital mortality rates. It can manifest following acute myocardial infarction or acute exacerbation of chronic heart failure. Despite advancements, mortality rates remain elevated, prompting interest in multidisciplinary approaches to improve outcomes. This manuscript presents a review focused on the concept of a CS team and its potential impact on patient management and outcomes. MethodsA comprehensive search was performed on March 19th, 2023, covering PubMed, Web of Science, Scopus, Embase, and Cochrane Library. We included primary studies (prospective and retrospective) only and evaluated their quality using the Newcastle-Ottawa Quality Scale. This review was registered in PROSPERO (CRD42023440354). ResultsSix relevant studies with 2066 CS patients were included, of which 1071 were managed by shock teams and 995 received standard care. Findings from the reviewed studies indicated the favorable outcomes associated with implementing CS teams. Patients managed by these teams exhibited higher 30-day and in-hospital survival rates compared to those without team intervention. The implementation of CS teams was linked to reduced in-hospital and ICU mortality rates. Additionally, shock team involvement was associated with shorter door-to-balloon times. ConclusionThis review highlighted the positive influence of CS teams on patient care, enabling early detection, timely interventions, and shorter ICU stays. Despite implementation challenges, CS teams hold promise for improving management outcomes, necessitating increased attention and ongoing research in multidisciplinary strategies to advance CS care.