Cargando…

Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study

BACKGROUND: Cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) complicates management of the condition, and often leads to poor prognosis. Prompt and accurate monitoring of cardiovascular and accompanying hemodynamic changes is crucial in achieving adequate management of the condi...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Yuan-Bo, Zhang, Zhi-Zhong, Li, Jun-Xia, Wang, Yu-Hong, Zhang, Wei-Lin, Tian, Xin-Li, Han, Yun-Feng, Yang, Meng, Liu, Yu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580342/
https://www.ncbi.nlm.nih.gov/pubmed/31236393
http://dx.doi.org/10.12998/wjcc.v7.i11.1291
_version_ 1783428007890780160
author Zhang, Yuan-Bo
Zhang, Zhi-Zhong
Li, Jun-Xia
Wang, Yu-Hong
Zhang, Wei-Lin
Tian, Xin-Li
Han, Yun-Feng
Yang, Meng
Liu, Yu
author_facet Zhang, Yuan-Bo
Zhang, Zhi-Zhong
Li, Jun-Xia
Wang, Yu-Hong
Zhang, Wei-Lin
Tian, Xin-Li
Han, Yun-Feng
Yang, Meng
Liu, Yu
author_sort Zhang, Yuan-Bo
collection PubMed
description BACKGROUND: Cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) complicates management of the condition, and often leads to poor prognosis. Prompt and accurate monitoring of cardiovascular and accompanying hemodynamic changes is crucial in achieving adequate management of the condition. Advances in technology has availed procedures such as pulse index continuous cardiac output (PiCCO), which can offer precise monitoring of cardiovascular functions and hemodynamic parameters. In this study, PiCCO is evaluated for its potential utility in improving management and clinical outcomes among elderly patients with AMI complicated by CS. AIM: To assess whether use of the PiCCO system can improve clinical outcomes in elderly patients with AMI complicated by CS. METHODS: Patients from emergency intensive care units (EICU) or coronary care units (CCU) were randomized to receive PiCCO monitoring or not. The APACHE II score, SOFA score, hs-TnI, NT-proBNP, PaO(2)/FiO(2) ratio and lactate levels on day 1, 3 and 7 after treatment were compared. The infusion and urine volume at 0-24 h, 24-48 h and 48-72 h were recorded, as were the cardiac index (CI), extravascular lung water index (EVLWI), intrathoracic blood volume index (ITBVI) and global end diastolic volume index (GEDVI) at similar time intervals. RESULTS: Sixty patients with AMI complicated by CS were included in the study. The PiCCO group had a significantly lower APACHE II score, SOFA score, hs-TnI and NT-proBNP levels on day 1, 3 and 7 after treatment. The infusion and urine volume during 0-24 h in the PiCCO group were significantly greater, and this group also showed significantly higher ADL scores. Furthermore, the PiCCO group spent lesser days on vasoactive agents, mechanical ventilation, and had a reduced length of stay in EICU/CCU. Additionally, the CI was significantly higher at 48 h and 72 h in the PiCCO group compared with that at 24 h, and the EVLWI, ITBVI and GEDVI were significantly decreased at 48 h and 72 h. CONCLUSION: Applying the PiCCO system could improve the clinical outcomes of elderly patients with AMI complicated by CS.
format Online
Article
Text
id pubmed-6580342
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-65803422019-06-24 Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study Zhang, Yuan-Bo Zhang, Zhi-Zhong Li, Jun-Xia Wang, Yu-Hong Zhang, Wei-Lin Tian, Xin-Li Han, Yun-Feng Yang, Meng Liu, Yu World J Clin Cases Prospective Study BACKGROUND: Cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) complicates management of the condition, and often leads to poor prognosis. Prompt and accurate monitoring of cardiovascular and accompanying hemodynamic changes is crucial in achieving adequate management of the condition. Advances in technology has availed procedures such as pulse index continuous cardiac output (PiCCO), which can offer precise monitoring of cardiovascular functions and hemodynamic parameters. In this study, PiCCO is evaluated for its potential utility in improving management and clinical outcomes among elderly patients with AMI complicated by CS. AIM: To assess whether use of the PiCCO system can improve clinical outcomes in elderly patients with AMI complicated by CS. METHODS: Patients from emergency intensive care units (EICU) or coronary care units (CCU) were randomized to receive PiCCO monitoring or not. The APACHE II score, SOFA score, hs-TnI, NT-proBNP, PaO(2)/FiO(2) ratio and lactate levels on day 1, 3 and 7 after treatment were compared. The infusion and urine volume at 0-24 h, 24-48 h and 48-72 h were recorded, as were the cardiac index (CI), extravascular lung water index (EVLWI), intrathoracic blood volume index (ITBVI) and global end diastolic volume index (GEDVI) at similar time intervals. RESULTS: Sixty patients with AMI complicated by CS were included in the study. The PiCCO group had a significantly lower APACHE II score, SOFA score, hs-TnI and NT-proBNP levels on day 1, 3 and 7 after treatment. The infusion and urine volume during 0-24 h in the PiCCO group were significantly greater, and this group also showed significantly higher ADL scores. Furthermore, the PiCCO group spent lesser days on vasoactive agents, mechanical ventilation, and had a reduced length of stay in EICU/CCU. Additionally, the CI was significantly higher at 48 h and 72 h in the PiCCO group compared with that at 24 h, and the EVLWI, ITBVI and GEDVI were significantly decreased at 48 h and 72 h. CONCLUSION: Applying the PiCCO system could improve the clinical outcomes of elderly patients with AMI complicated by CS. Baishideng Publishing Group Inc 2019-06-06 2019-06-06 /pmc/articles/PMC6580342/ /pubmed/31236393 http://dx.doi.org/10.12998/wjcc.v7.i11.1291 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Prospective Study
Zhang, Yuan-Bo
Zhang, Zhi-Zhong
Li, Jun-Xia
Wang, Yu-Hong
Zhang, Wei-Lin
Tian, Xin-Li
Han, Yun-Feng
Yang, Meng
Liu, Yu
Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study
title Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study
title_full Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study
title_fullStr Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study
title_full_unstemmed Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study
title_short Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study
title_sort application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: a prospective randomized study
topic Prospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580342/
https://www.ncbi.nlm.nih.gov/pubmed/31236393
http://dx.doi.org/10.12998/wjcc.v7.i11.1291
work_keys_str_mv AT zhangyuanbo applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy
AT zhangzhizhong applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy
AT lijunxia applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy
AT wangyuhong applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy
AT zhangweilin applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy
AT tianxinli applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy
AT hanyunfeng applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy
AT yangmeng applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy
AT liuyu applicationofpulseindexcontinuouscardiacoutputsysteminelderlypatientswithacutemyocardialinfarctioncomplicatedbycardiogenicshockaprospectiverandomizedstudy