Impella support compared to medical treatment for post-cardiac arrest shock after out of hospital cardiac arrest
| Autor: | Georgios Chatzis, Konstantinos Karatolios, Clemens Kill, Susanne Betz, Ulrich Luesebrink, Birgit Markus, Bernhard Schieffer, Wolfgang Dersch, Elisabeth Boesl, William W. O'Neill, Holger Ahrens, Birgit Ploeger |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Organ Dysfunction Scores Shock Cardiogenic Comorbidity 030204 cardiovascular system & hematology Emergency Nursing Single Center Out of hospital cardiac arrest 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Post cardiac arrest Myocardial infarction Propensity Score Impella Aged Retrospective Studies Aged 80 and over Medical treatment business.industry Cardiogenic shock 030208 emergency & critical care medicine Length of Stay Middle Aged medicine.disease Treatment Outcome Shock (circulatory) Emergency Medicine Cardiology Female Heart-Assist Devices medicine.symptom Cardiology and Cardiovascular Medicine business Out-of-Hospital Cardiac Arrest |
| Zdroj: | Resuscitation. 126:104-110 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/j.resuscitation.2018.03.008 |
| Popis: | To compare survival outcomes of Impella support and medical treatment in patients with post-cardiac arrest cardiogenic shock related to acute myocardial infarction (AMI).Retrospective single center study of patients resuscitated from out of hospital cardiac arrest (OHCA) due to AMI with post-cardiac arrest cardiogenic shock between September 2014 and September 2016. Patients were either assisted with Impella or received medical treatment only. Survival outcomes were compared using propensity score-matched analysis to account for differences in baseline characteristics between both groups.A total of 90 consecutive patients with post-cardiac arrest shock due to AMI were included; 27 patients in the Impella group and 63 patients in the medical treatment group. Patients with Impella support had a longer duration of low-flow time (29.54 ± 10.21 versus 17.57 ± 8.3 min, p 0.001), higher lactate levels on admission (4.75 [IQR 3.8-11] versus 3.6 [IQR 2.6-3.9] mmol/L, p = 0.03) and lower baseline systolic LVEF (25% [IQR 25-35] versus 45% [IQR 35-51.25], p 0.001) as compared to patients without circulatory support. After propensity score matching, patients with Impella support had a significantly higher survival to hospital discharge (65% versus 20%, p = 0.01) and 6-months survival (60% versus 20%, p = 0.02).The results from our study suggest that Impella support is associated with significantly better survival to hospital discharge and at 6 months compared to medical treatment in OHCA patients admitted with post-cardiac arrest cardiogenic shock and AMI. |
| Databáze: | OpenAIRE |
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