Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study

Background: Despite scarce data, invasive mechanical ventilation (MV) is widely recommended over noninvasive ventilation (NIV) for ventilatory support in cardiogenic shock (CS). We assessed the real-life use of different ventilation strategies in CS and their influence on outcome focusing on the use...

Full description

Bibliographic Details
Authors: Hongisto, M, Lassus, J, Tarvasmaki, T, Sionis, A, Tolppanen, H, Lindholm, MG, Banaszewski, M, Parissis, J, Spinar, J, Silva-Cardoso, J, Carubelli, V, Di Somma, S, Masip, J, Harjola, VP
Format: article
Status:Published version
Publication Date:2017
Country:España
Institution:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repository:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p6600
Online Access:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6600
https://hdl.handle.net/11573/927766
Access Level:Open access
Keyword:Cardiogenic shock
Noninvasive ventilation
Mechanical ventilation
Acute coronary syndrome
Ventilation
Acute myocardial infarction
id ES_7f622a4e213f6da2c59d0871a00045b3
oai_identifier_str oai:iibsantpau.fundanetsuite.com:p6600
network_acronym_str ES
network_name_str España
repository_id_str
spelling Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter studyHongisto, MLassus, JTarvasmaki, TSionis, ATolppanen, HLindholm, MGBanaszewski, MParissis, JSpinar, JSilva-Cardoso, JCarubelli, VDi Somma, SMasip, JHarjola, VPCardiogenic shockNoninvasive ventilationMechanical ventilationAcute coronary syndromeVentilationAcute myocardial infarctionBackground: Despite scarce data, invasive mechanical ventilation (MV) is widely recommended over noninvasive ventilation (NIV) for ventilatory support in cardiogenic shock (CS). We assessed the real-life use of different ventilation strategies in CS and their influence on outcome focusing on the use of NIV and MV. Methods: 219 CS patients were categorized by the maximum intensity of ventilatory support they needed during the first 24 h into MV (n= 137; 63%), NIV(n= 26; 12%), and supplementary oxygen (n= 56; 26%) groups. We compared the clinical characteristics and 90-day outcome between the MV and the NIV groups. Results: Mean age was 67 years, 74% were men. The MV and NIV groups did not differ in age, medical history, etiology of CS, PaO2/FiO(2) ratio, baseline hemodynamics or LVEF. MV patients predominantly presented with hypoperfusion, with more severe metabolic acidosis, higher lactate levels and greater need for vasoactive drugs, whereas NIV patients tended to be more often congestive. 90-day outcome was significantly worse in the MV group (50% vs. 27%), but after propensity score adjustment, mortality was equal in both groups. Confusion, prior CABG, ACS etiology, higher lactate level, and lower baseline PaO2 were independent predictors of mortality, where as ventilation strategy did not have any influence on outcome. Conclusions: Although MV is generally recommended mode of ventilatory support in CS, a fair number of patients were successfully treated with NIV. Moreover, ventilation strategy was not associated with outcome. Thus, NIV seems a safe option for properly chosen CS patients. (C) 2016 Elsevier Ireland Ltd. All rights reserved.ELSEVIER IRELAND LTD2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6600https://hdl.handle.net/11573/927766INTERNATIONAL JOURNAL OF CARDIOLOGYISSN: 01675273ISSNe: 18741754reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p66002026-06-14T12:41:47Z
dc.title.none.fl_str_mv Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study
title Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study
spellingShingle Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study
Hongisto, M
Cardiogenic shock
Noninvasive ventilation
Mechanical ventilation
Acute coronary syndrome
Ventilation
Acute myocardial infarction
title_short Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study
title_full Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study
title_fullStr Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study
title_full_unstemmed Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study
title_sort Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study
dc.creator.none.fl_str_mv Hongisto, M
Lassus, J
Tarvasmaki, T
Sionis, A
Tolppanen, H
Lindholm, MG
Banaszewski, M
Parissis, J
Spinar, J
Silva-Cardoso, J
Carubelli, V
Di Somma, S
Masip, J
Harjola, VP
author Hongisto, M
author_facet Hongisto, M
Lassus, J
Tarvasmaki, T
Sionis, A
Tolppanen, H
Lindholm, MG
Banaszewski, M
Parissis, J
Spinar, J
Silva-Cardoso, J
Carubelli, V
Di Somma, S
Masip, J
Harjola, VP
author_role author
author2 Lassus, J
Tarvasmaki, T
Sionis, A
Tolppanen, H
Lindholm, MG
Banaszewski, M
Parissis, J
Spinar, J
Silva-Cardoso, J
Carubelli, V
Di Somma, S
Masip, J
Harjola, VP
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cardiogenic shock
Noninvasive ventilation
Mechanical ventilation
Acute coronary syndrome
Ventilation
Acute myocardial infarction
topic Cardiogenic shock
Noninvasive ventilation
Mechanical ventilation
Acute coronary syndrome
Ventilation
Acute myocardial infarction
description Background: Despite scarce data, invasive mechanical ventilation (MV) is widely recommended over noninvasive ventilation (NIV) for ventilatory support in cardiogenic shock (CS). We assessed the real-life use of different ventilation strategies in CS and their influence on outcome focusing on the use of NIV and MV. Methods: 219 CS patients were categorized by the maximum intensity of ventilatory support they needed during the first 24 h into MV (n= 137; 63%), NIV(n= 26; 12%), and supplementary oxygen (n= 56; 26%) groups. We compared the clinical characteristics and 90-day outcome between the MV and the NIV groups. Results: Mean age was 67 years, 74% were men. The MV and NIV groups did not differ in age, medical history, etiology of CS, PaO2/FiO(2) ratio, baseline hemodynamics or LVEF. MV patients predominantly presented with hypoperfusion, with more severe metabolic acidosis, higher lactate levels and greater need for vasoactive drugs, whereas NIV patients tended to be more often congestive. 90-day outcome was significantly worse in the MV group (50% vs. 27%), but after propensity score adjustment, mortality was equal in both groups. Confusion, prior CABG, ACS etiology, higher lactate level, and lower baseline PaO2 were independent predictors of mortality, where as ventilation strategy did not have any influence on outcome. Conclusions: Although MV is generally recommended mode of ventilatory support in CS, a fair number of patients were successfully treated with NIV. Moreover, ventilation strategy was not associated with outcome. Thus, NIV seems a safe option for properly chosen CS patients. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
publishDate 2017
dc.date.none.fl_str_mv 2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6600
https://hdl.handle.net/11573/927766
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=6600
https://hdl.handle.net/11573/927766
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER IRELAND LTD
publisher.none.fl_str_mv ELSEVIER IRELAND LTD
dc.source.none.fl_str_mv INTERNATIONAL JOURNAL OF CARDIOLOGY
ISSN: 01675273
ISSNe: 18741754
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869411820260818944
score 15,198674

Similar Items