STUDY OBJECTIVES: To characterize the hemodynamic course of cardiogenic shock and to relate the cause of death to ongoing cardiac failure or multiple organ dysfunction. DESIGN: Retrospective study. SETTING: A 31-bed department of intensive care in a university hospital. PATIENTS: All patients admitted for cardiogenic shock from January 1999 to December 2000. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Charts were reviewed for demographic, clinical, hemodynamic, oxygen transport, inflammation, and organ dysfunction data. Of 62 patients with cardiogenic shock, 40 (65%) did not survive. Eight patients (20%) died from fatal arrhythmia, 14 patients (35%) died with low cardiac index (CI) [ie, < 2.2 L/min/m(2)], and 18 patients (45%) died with normalized CI (ie, > 2.2 L/min/m(2)) and a higher CI/oxygen extraction ratio. Of these 18 patients, 9 had evidence of infection. The patients with normalized CI were younger and stayed longer in the ICU than patients with low CI. CONCLUSION: A substantial number of patients with cardiogenic shock die with a normalized CI, suggesting a distributive defect, in the absence of obvious infection. These patients are younger and have a longer ICU course. The release of mediators may be secondary to gut hypoperfusion.
STUDY OBJECTIVES: To characterize the hemodynamic course of cardiogenic shock and to relate the cause of death to ongoing cardiac failure or multiple organ dysfunction. DESIGN: Retrospective study. SETTING: A 31-bed department of intensive care in a university hospital. PATIENTS: All patients admitted for cardiogenic shock from January 1999 to December 2000. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Charts were reviewed for demographic, clinical, hemodynamic, oxygen transport, inflammation, and organ dysfunction data. Of 62 patients with cardiogenic shock, 40 (65%) did not survive. Eight patients (20%) died from fatal arrhythmia, 14 patients (35%) died with low cardiac index (CI) [ie, < 2.2 L/min/m(2)], and 18 patients (45%) died with normalized CI (ie, > 2.2 L/min/m(2)) and a higher CI/oxygen extraction ratio. Of these 18 patients, 9 had evidence of infection. The patients with normalized CI were younger and stayed longer in the ICU than patients with low CI. CONCLUSION: A substantial number of patients with cardiogenic shock die with a normalized CI, suggesting a distributive defect, in the absence of obvious infection. These patients are younger and have a longer ICU course. The release of mediators may be secondary to gut hypoperfusion.
Authors: Corstiaan A den Uil; Kadir Caliskan; Wim K Lagrand; Martin van der Ent; Lucia S D Jewbali; Jan P van Kuijk; Peter E Spronk; Maarten L Simoons Journal: Intensive Care Med Date: 2009-07-29 Impact factor: 17.440
Authors: Thor Allan Stenberg; Anders Benjamin Kildal; Espen Sanden; Ole-Jakob How; Martin Hagve; Kirsti Ytrehus; Terje S Larsen; Truls Myrmel Journal: PLoS One Date: 2014-09-04 Impact factor: 3.240