Expert Consensus Statement on the Evaluation, Treatment, and Transfer of Cardiogenic Shock Using a Delphi Method Approach　― A Report of the Japan Critical Care Cardiology Committee (J4CS) ―

Takahiro Nakashima; Toru Kondo; Jun Nakata; Keita Saku; Shoji Kawakami; Masanari Kuwabara; Takeshi Yamamoto; Migaku Kikuchi; Ichiro Takeuchi; Kuniya Asai; Naoki Sato; on behalf of the Japanese Circulation Society Emergency and Critical Care Committee and the Japanese Society of Intensive Care Medicine Cardiovascular Intensive Care Committee

doi:10.1253/circj.CJ-25-0192

JCS Statement

Expert Consensus Statement on the Evaluation, Treatment, and Transfer of Cardiogenic Shock Using a Delphi Method Approach　― A Report of the Japan Critical Care Cardiology Committee (J4CS) ―

Takahiro Nakashima , Toru Kondo, Jun Nakata, Keita Saku, Shoji Kawakami, Masanari Kuwabara, Takeshi Yamamoto, Migaku Kikuchi, Ichiro Takeuchi, Kuniya Asai, Naoki Sato, on behalf of the Japanese Circulation Society Emergency and Critical Care Committee and the Japanese Society of Intensive Care Medicine Cardiovascular Intensive Care Committee

Author information

Takahiro Nakashima Corresponding author
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University [Japan]
Toru Kondo
Department of Cardiology, Nagoya University Graduate School of Medicine [Japan]
Jun Nakata
Division of Cardiovascular Intensive Care, Nippon Medical School Hospital [Japan]
Keita Saku
Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center [Japan]
Shoji Kawakami
Department of Cardiology, Aso Iizuka Hospital [Japan]
Masanari Kuwabara
Division of Public Health, Center for Community Medicine, Jichi Medical University [Japan]
Division of Cardiovascular Medicine, Jichi Medical University [Japan]
Takeshi Yamamoto
Division of Cardiovascular Intensive Care, Nippon Medical School Hospital [Japan]
Migaku Kikuchi
Emergency and Critical Care Center, Dokkyo Medical University [Japan]
Ichiro Takeuchi
Department of Emergency Medicine, Yokohama City University [Japan]
Kuniya Asai
Division of Cardiovascular Intensive Care, Nippon Medical School Hospital [Japan]
Naoki Sato
Department of Cardiovascular Medicine, Kawaguchi Cardiovascular and Respiratory Hospital [Japan]
on behalf of the Japanese Circulation Society Emergency and Critical Care Committee and the Japanese Society of Intensive Care Medicine Cardiovascular Intensive Care Committee

JOURNAL OPEN ACCESS FULL-TEXT HTML

2025 Volume 89 Issue 7 Pages 998-1011

DOI https://doi.org/10.1253/circj.CJ-25-0192

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Details

Published: June 25, 2025 Received: - Released on J-STAGE: June 25, 2025 Accepted: - Advance online publication
Version 3 :April 24, 2025
Version 2 :April 16, 2025
Version 1 :March 29, 2025
Revised: -
Version information of Advance online publication
Published online: April 24, 2025 Reason for change: Updated to full XML version. Changed from previous version: Full-text HTML Summary of changes: Updated to full XML version.

Published online: April 16, 2025 Reason for change:
The authors apologize for the error. Changed from previous version: Fulltext PDF Summary of changes:
Figure 1 legend,
Incorrect:
CICU, cardiovascular intensive care unit; JCS, Japanese Cardiology Society
Correct:
CICU, cardiac intensive care unit; JCS, Japanese Circulation Society

Figure 2,
Incorrect:
STEP 3
HR: 50-120beats/min
Serial follow-up
Complete lactate clearance (≤2 mmol/L)
Correct:
STEP 3
HR: 50-100beats/min
Serial follow-up
Complete lactate clearance (<2 mmol/L)

Figure 2 legend,
Incorrect:
cardiovascular intensive care unit (CICU)
Correct:
cardiac intensive care unit (CICU)
Delete the following statement:
“The blue arrows indicate institutional actions, and the red arrows represent consultations or patient transfers between hospitals.”

Figure 3 legend,
Incorrect:
The green dots represent typical checkpoints, and the purple dots ...
Correct:
The yellow dots represent typical checkpoints, and the green dots ...

Table 1,
Incorrect:
“Statement” column, near line 4
Respiratory rate
Correct:
“Statement” column, near line 4
Respiratory rate ≥22 /min

Table 5,
Incorrect:
“Statement” column, near line 4
Respiratory rate
“Statement” column, near line 6
Urine output ≥0.5 mL/h
Correct:
“Statement” column, near line 4
Respiratory rate <20 /min
“Statement” column, near line 6
Urine output ≥0.5 mL/kg/h

Text, “Methods” section,
Incorrect:
... cardiac intensive care unit (CICU) or cardiovascular
intensive care unit.
Correct:
... cardiac intensive care unit (CICU) or cardiovascular
intensive care unit (CVICU).

Text, “Consensus”, “Additional Step: Advanced Assessment/Treatment” section,
Incorrect:
... (FMC2D) target is <90 min for patients presenting directly
to a PCI-capable center and <120 min for those requiring
interhospital transfer.
Correct:
... (FMC2D) target is ≤90 min for patients presenting directly
to a PCI-capable center and ≤120 min for those requiring
interhospital transfer.

Text, “Consensus”, “Step 3: Management in the CICU” section,
Incorrect:
... cardiac power output, ≥0.6 W; pulmonary artery wedge
pressure <18 mmHg; and mixed venous oxygen saturation ≥60%.
Correct:
... cardiac power output, ≥0.6 W; pulmonary capillary wedge
pressure <18 mmHg; and mixed venous oxygen saturation ≥60%.

Corresponding author

Version information of Advance online publication

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