How To Session: Cardiogenic Shock

Cardiogenic shock confers significant morbidity and mortality. Various cardiac injuries can lead to decreased cardiac output and end-organ perfusion. Timely recognition of cardiogenic shock is key to improved survival. Accurate assessment of the degree, and phenotype, of cardiogenic shock is key to appropriate decision-making regarding use of vasoactive medications and temporary mechanical circulatory support (MCS) devices. This workshop will focus on hands-on use of temporary MCS devices, including basic interpretation of outputs, functional adjustments, and common alarms and trouble-shooting.

Agenda

20-minute rotations: 2-minute station transition/announcement + 18-minute station session

• Station 1 – Intra-aortic Balloon Pump: In this station, participants will directly interact with the IABP console, adjusting balloon inflation and timing. They will go through common alarms and malfunctions to learn how to troubleshoot these common issues. 
• Station 2 – Percutaneous Left- and Right-Ventricular Mechanical Circulatory Support: Impella RP, Impella 5.5, and Impella CP: In this station, participants will learn about selection of device therapies based on cardiogenic shock phenotypes. Lastly, participants will learn about interpreting provider-facing, device-related data (i.e. speed, flow, waveforms, pressures, etc), adjusting levels of support, common complications, and alarm troubleshooting. 
• Station 3 – Biventricular Mechanical Circulatory Support: In this station, participants will learn about ECMO configurations based on cardiogenic shock phenotypes. They will also learn about interpreting provider-facing, device-related data (i.e. speed, flow, oxygenation, sweep), adjusting levels of support, common complications, and alarm troubleshooting.

Learning Objectives 

Following this activity, participants will be better able to:

• Describe the basics of IABP console interpretation and how to trouble shoot common alarms and malfunctions
• Discuss the basics of Impella console interpretation and how to trouble shoot common alarms and malfunctions
• Explain the basics of ECMO console interpretation and how to trouble shoot common alarms and malfunctions