LSCSI is a Hub\&Spoke project with the main aim to improve the outcome of patients with cardiogenic shock in Lower Silesia region, Poland. It consists of one hub which is Wroclaw University Hospital and eleven spokes which are eleven cardiology departments situated in Lower Silesian Voivodeship. The consortium have unified protocol defining which cardiogenic shock patient and when should be transferred to the hub for enhanced treatment options including durable mechanical circulatory support or heart transplant. The hub have 7/24 Shock Team on-site supplied with a protocol how to proceed with spoke transferred patients including decision making on which mechanical circulatory support implant with subsequent de-escalation or escalation pathway.