Current Use and Impact on 30-Day Mortality of Pulmonary Artery Catheter in Cardiogenic Shock Patients: Results From the CardShock Study

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Sionis, A (Author) Other; Rivas Lasarte, M (Author) Other; Mebazaa, A (Author) Other; Tarvasmaki, T (Author) Other; Sans Rosello, J (Author) Other; Tolppanen, H (Author) Other; Varpula, M (Author) Other; Jurkko, R (Author) Other; Banaszewski, M (Author) Other; Silva Cardoso, J (Author) FMUP; Carubelli, V (Author) Other; Lindholm, MG (Author) Other; Parissis, J (Author) Other; Spinar, J (Author) Other; Lassus, J (Author) Other; Harjola, VP (Author) Other; Masip, J (Author) Other

Journal

The Journal is awaiting validation by the Administrative Services.

Title: JOURNAL OF INTENSIVE CARE MEDICINE

Vol. 35

Pages: 1426-1433

ISSN: 0885-0666

Indexing

ISI Web of Knowledge - 18 Citations

Scopus - 20 Citations

Other information

Authenticus ID: P-00Q-8HA

DOI: 10.1177/0885066619828959

Abstract (EN): 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.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8