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

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 o...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2020-12, Vol.15 (12), p.e0244294-e0244294
Main Authors: Josiassen, Jakob, Lerche Helgestad, Ole Kristian, Møller, Jacob Eifer, Kjaergaard, Jesper, Hoejgaard, Henrik Frederiksen, Schmidt, Henrik, Jensen, Lisette Okkels, Holmvang, Lene, Ravn, Hanne Berg, Hassager, Christian
Format: Article
Language:English
Subjects:
Acute Disease
Aged
Cardiac arrest
Cardiogenic shock
Care and treatment
Cohort Studies
Comparative analysis
Complications and side effects
Demographic aspects
Emergency medical services
Female
Health aspects
Heart attack
Heart-Assist Devices - adverse effects
Hemodynamics
Hemodynamics - physiology
Humans
Intensive Care Units - trends
Male
Medicine and Health Sciences
Middle Aged
Myocardial Infarction - epidemiology
Myocardial Infarction - metabolism
Myocardial Infarction - therapy
Out-of-Hospital Cardiac Arrest - etiology
Patient outcomes
People and Places
Risk Factors
Shock, Cardiogenic - epidemiology
Shock, Cardiogenic - metabolism
Shock, Cardiogenic - therapy
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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. 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. 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
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0244294