Clément Delmas1, Etienne Puymirat2, Guillaume Leurent3, Meyer Elbaz4, Stéphane Manzo-Silberman5, Laurent Bonello6, Edouard Gerbaud7, Vincent Bataille8, Bruno Levy9, Nicolas Lamblin10, Eric Bonnefoy11, Patrick Henry5, François Roubille12. 1. Intensive cardiac care unit, cardiology department, university hospital of Rangueil, 31059 Toulouse, France. Electronic address: delmas.clement@chu-toulouse.fr. 2. Cardiology department, hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France. 3. Department of Cardiology, CHU Rennes, 35000 Rennes, France; Inserm LTSI-UMR 1099, Rennes university, 35043 Rennes, France. 4. Intensive cardiac care unit, cardiology department, university hospital of Rangueil, 31059 Toulouse, France. 5. Intensive cardiac care unit, cardiology department, Lariboisière university hospital, AP-HP, 75010 Paris, France; UMR S-942, université Paris Diderot, 75010 Paris, France. 6. Intensive care unit, department of cardiology, hôpital Nord, AP-HM, 13015 Marseille, France; Mediterranean Association for research and studies in cardiology (MARS Cardio), 13015 Marseille, France; Inserm 1263, Inra 1260, Centre for cardiovascular and nutrition research (C2VN), Aix-Marseille university, 13385 Marseille, France. 7. Cardiology intensive care unit and interventional cardiology, hôpital cardiologique du Haut Lévêque, 33600 Pessac, France; Inserm U1045, Bordeaux cardio-thoracic research centre, Bordeaux university, 33607 Bordeaux, France. 8. Association pour la diffusion de la médecine de prévention (ADIMEP), 31400 Toulouse, France. 9. Pôle cardio-médico-chirurgical, service de réanimation médicale Brabois, CHRU Nancy, 54500 Vandoeuvre-lès-Nancy, France; Inserm U1116, faculté de médecine, université de Lorraine, 54500 Vandoeuvre-lès-Nancy, France. 10. Inserm U1167, institut Pasteur de Lille, CHU Lille, université de Lille, 59019 Lille, France. 11. Hospices Civils de Lyon, université Claude Bernard Lyon 1, 69002 Lyon, France. 12. Inserm, CNRS, PhyMedExp, cardiology department, université de Montpellier, CHU de Montpellier, 34295 Montpellier, France.
Abstract
BACKGROUND: Most data on the epidemiology of cardiogenic shock (CS) have come from patients with acute myocardial infarction admitted to intensive cardiac care units (ICCUs). However, CS can have other aetiologies, and could be managed in intensive care units (ICUs), especially the most severe forms of CS. AIM: To gather data on the characteristics, management and outcomes of patients hospitalized in ICCUs and ICUs for CS, whatever the aetiology, in France in 2016. METHODS: We included all adult patients with CS between April and October 2016 in metropolitan France. CS was defined (at admission or during hospitalization) by: low cardiac output, defined by systolic blood pressure<90mmHg and/or the need for amines to maintain systolic blood pressure>90mmHg and/or cardiac index<2.2L/min/m2; elevation of the left and/or right heart pressures, defined by clinical, radiological, biological, echocardiographic or invasive haemodynamic overload signs; and clinical and/or biological signs of malperfusion (lactate>2mmol/L, hepatic insufficiency, renal failure). RESULTS: Over a 6-month period, 772 patients were included in the survey (mean age 65.7±14.9 years; 71.5% men) from 49 participating centres (91.8% were public, and 77.8% of these were university hospitals). Ischaemic trigger was the most common cause (36.3%). CONCLUSIONS: To date, FRENSHOCK is the largest CS survey; it will provide a detailed and comprehensive global description of the spectrum and management of patients with CS in a high-income country.
BACKGROUND: Most data on the epidemiology of cardiogenic shock (CS) have come from patients with acute myocardial infarction admitted to intensive cardiac care units (ICCUs). However, CS can have other aetiologies, and could be managed in intensive care units (ICUs), especially the most severe forms of CS. AIM: To gather data on the characteristics, management and outcomes of patients hospitalized in ICCUs and ICUs for CS, whatever the aetiology, in France in 2016. METHODS: We included all adult patients with CS between April and October 2016 in metropolitan France. CS was defined (at admission or during hospitalization) by: low cardiac output, defined by systolic blood pressure<90mmHg and/or the need for amines to maintain systolic blood pressure>90mmHg and/or cardiac index<2.2L/min/m2; elevation of the left and/or right heart pressures, defined by clinical, radiological, biological, echocardiographic or invasive haemodynamic overload signs; and clinical and/or biological signs of malperfusion (lactate>2mmol/L, hepatic insufficiency, renal failure). RESULTS: Over a 6-month period, 772 patients were included in the survey (mean age 65.7±14.9 years; 71.5% men) from 49 participating centres (91.8% were public, and 77.8% of these were university hospitals). Ischaemic trigger was the most common cause (36.3%). CONCLUSIONS: To date, FRENSHOCK is the largest CS survey; it will provide a detailed and comprehensive global description of the spectrum and management of patients with CS in a high-income country.