KOBV-Portal

Treffer pro Seite

Treffer 1 - 1 | 1 Treffer

Alles auswählen Exportieren

Online-Ressource

Hemodynamic and metabolic recovery in acute myocardial infarction-related cardiogenic shock is more rapid among patients presenting with out-of-hospital cardiac arrest

Josiassen, Jakob ; Lerche Helgestad, Ole Kristian ; Møller, Jacob Eifer ; [weitere]

Public Library of Science (PLoS) ; 2020

In: PLOS ONE Vol. 15, No. 12 ( 2020-12-23), p. e0244294-

zur Merkliste hinzufügen auf der Merkliste

Details

In: PLOS ONE, Public Library of Science (PLoS), Vol. 15, No. 12 ( 2020-12-23), p. e0244294-

Kurzfassung: Most studies in acute myocardial infarction complicated by cardiogenic shock (AMICS) include patients presenting with and without out-of-hospital cardiac arrest (OHCA). The aim was to compare OHCA and non-OHCA AMICS patients in terms of hemodynamics, management in the intensive care unit (ICU) and outcome. Methods From a cohort corresponding to two thirds of the Danish population, all patients with AMICS admitted from 2010–2017 were individually identified through patient records. Results A total of 1716 AMICS patients were identified of which 723 (42%) presented with OHCA. A total of 1532 patients survived to ICU admission. At the time of ICU arrival, there were no differences between OHCA and non-OHCA AMICS patients in variables commonly used in the AMICS definition (mean arterial pressure (MAP) (72mmHg vs 70mmHg, p = 0.12), lactate (4.3mmol/L vs 4.0mmol/L, p = 0.09) and cardiac output (CO) (4.6L/min vs 4.4L/min, p = 0.30)) were observed. However, during the initial days of ICU treatment OHCA patients had a higher MAP despite a lower need for vasoactive drugs, higher CO, SVO2 and lactate clearance compared to non-OHCA patients (p 〈 0.05 for all). In multivariable analysis outcome was similar but cause of death differed significantly with hypoxic brain injury being leading cause in OHCA and cardiac failure in non-OHCA AMICS patients. Conclusion OHCA and non-OHCA AMICS patients initially have comparable metabolic and hemodynamic profiles, but marked differences develop between the groups during the first days of ICU treatment. Thus, pooling of OHCA and non-OHCA patients as one clinical entity in studies should be done with caution.

Materialart: Online-Ressource

ISSN: 1932-6203

URL: Article