Portal de investigação
Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study
Autores da FMUP
Participantes de fora da FMUP
- Sionis, A
- Rivas-Lasarte, M
- Mebazaa, A
- Tarvasmäki, T
- Sans-Roselló, J
- Tolppanen, H
- Varpula, M
- Jurkko, R
- Banaszewski, M
- Carubelli, V
- Lindholm, MG
- Parissis, J
- Spinar, J
- Lassus, J
- Harjola, VP
- Masip, J
Unidades de investigação
Abstract
Background: Cardiogenic shock (CS) is the most life-threatening manifestation of acute heart failure. Its complexity and high in-hospital mortality may justify the need for invasive monitoring with a pulmonary artery catheter (PAC). Methods: Patients with CS included in the CardShock Study, an observational, prospective, multicenter, European registry, were analyzed, aiming to describe the real-world use of PAC, evaluate its impact on 30-day mortality, and the ability of different hemodynamic parameters to predict outcomes. Results: Pulmonary artery catheter was used in 82 (37.4%) of the 219 patients. Cardiogenic shock patients who managed with a PAC received more frequently treatment with inotropes and vasopressors, mechanical ventilation, renal replacement therapy, and mechanical assist devices (P < .01). Overall 30-day mortality was 36.5%. Pulmonary artery catheter use did not affect mortality even after propensity score matching analysis (hazard ratio = 1.17 [0.59-2.32], P = .66). Cardiac index, cardiac power index (CPI), and stroke volume index (SVI) showed the highest areas under the curve for 30-day mortality (ranging from 0.752-0.803) and allowed for a significant net reclassification improvement of 0.467 (0.083-1.180), 0.700 (0.185-1.282), 0.683 (0.168-1.141), respectively, when added to the CardShock risk score. Conclusions: In our contemporary cohort of CS, over one-third of patients were managed with a PAC. Pulmonary artery catheter use was associated with a more aggressive treatment strategy. Nevertheless, PAC use was not associated with 30-day mortality. Cardiac index, CPI, and SVI were the strongest 30-day mortality predictors on top of the previously validated CardShock risk score.
Dados da publicação
- ISSN/ISSNe:
- 1525-1489, 0885-0666
- Tipo:
- Article
- Páginas:
- 1426-1433
- Link para outro recurso:
- www.scopus.com
Journal of Intensive Care Medicine SAGE Publications Inc.
Citações Recebidas na Web of Science: 37
Citações Recebidas na Scopus: 49
Documentos
- Não há documentos
Filiações
Keywords
- cardiogenic shock; mortality; pulmonary artery catheter; cardiac index; stroke volume index; cardiac power index
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Citar a publicação
Sionis A,Rivas M,Mebazaa A,Tarvasmäki T,Sans J,Tolppanen H,Varpula M,Jurkko R,Banaszewski M,Silva J,Carubelli V,Lindholm MG,Parissis J,Spinar J,Lassus J,Harjola VP,Masip J. Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study. J. Intensive Care Med. 2020. 35. (12):p. 1426-1433. IF:3,510. (2).
