SCA @ STS Addresses Evaluation, Management of Circulatory Shock

Jay G. Shake, MD

On the heels of last year’s successful SCA @ STS session, planners from the Society of Cardiovascular Anesthesiologists and STS have created a compelling new program centering on perioperative evaluation and management of circulatory shock.

“Anesthesiologists and surgeons work together in the operating room, so both groups experience shock perioperatively,” said Jay G. Shake, MD, Jackson, Miss. Dr. Shake, Aaron M. Cheng, MD, Seattle, and Jerrold H. Levy, MD, Durham, N.C., are co-moderators of the session, which will be from 3:30 p.m. to 5:30 p.m. Tuesday in Room 126ABC.

Leaders in their fields will discuss how to identify shock in challenging postoperative cardiac patients, perioperative hemodynamic monitoring, and pharmacologic management and mechanical support for shock.

When patients present with acute circulatory failure, their surgeons are left with several questions: “When should we make the decision that we need mechanical support?, Which is the right support?, Are there any cost considerations?, and Do we have data to support some of this?,” Dr. Shake posed. “Sometimes, it isn’t crystal clear. I think these talks will make for a stimulating discussion.”

Dr. Levy will look at shock in difficult patients.

“I think Dr. Levy will give a good review and also discuss the areas that challenge us, such as patient management of individuals with left ventricular assist devices, mechanical support, and low ejection fraction,” said Dr. Shake, Associate Professor, Director of the Cardiovascular Intensive Care Unit, Director of Adult Extracorporeal Membrane Oxygenation, and Co-Director of the Wallace Conerly Critical Care Hospital at the University of Mississippi Medical Center in Jackson.

With new technologies for perioperative hemodynamic monitoring now available, Robert Sladen, MD, New York, will compare options for surgeons, such as noninvasive cardiac output devices, as well as conventional options.

“Everyone is trying to come at this from different angles,” said Dr. Shake, “but what are our choices, and are there data to support one technology over another?”

In his talk on proven strategies for pharmacologic management of shock, Peter von Homeyer, MD, Seattle, will dig into recent prospective trials and share evidence for choosing pharmacological agents to treat circulatory failure.

The last speaker, Ashish Shah, MD, Nashville, Tenn., will identify indications, options, and outcomes for using mechanical circulatory support devices in these patients.