Hemodynamic and metabolic recovery in acute myocardial infarction-related cardiogenic shock is more rapid among patients presenting with out-of-hospital cardiac arrest

• DOI: 10.1371/journal.pone.0244294
• Publication Date: 2020-12-23T19:44:52Z
• Authors: Jakob Josiassen; Ole Kristian Lerc...; Jacob Eifer Møller; Jesper Kjaergaard; Henrik Frederikse...; Henrik Schmidt; Lisette Okkels Je...; Lene Holmvang; Hanne Berg Ravn; Christian Hassager
• Keywords: Male; Science; Q; R; Hemodynamics; Myocardial Infarction; Shock, Cardiogenic; Middle Aged; 3. Good health; Cohort Studies; Intensive Care Units; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Risk Factors; Acute Disease; Medicine; Humans; Female; Heart-Assist Devices; Out-of-Hospital Cardiac Arrest; Research Article; Aged

Most studies in acute myocardial infarction complicated by cardiogenic shock (AMICS) include patients presenting with and without out-of-hospital cardiac arrest (OHCA). The aim was to compare OHCA non-OHCA AMICS terms of hemodynamics, management the intensive care unit (ICU) outcome.From a cohort corresponding two thirds Danish population, all admitted from 2010-2017 were individually identified through patient records.A total 1716 which 723 (42%) presented OHCA. A 1532 survived ICU admission. At time arrival, there no differences between variables commonly used definition (mean arterial pressure (MAP) (72mmHg vs 70mmHg, p = 0.12), lactate (4.3mmol/L 4.0mmol/L, 0.09) output (CO) (4.6L/min 4.4L/min, 0.30)) observed. However, during initial days treatment had higher MAP despite lower need for vasoactive drugs, CO, SVO2 clearance compared (p<0.05 all). In multivariable analysis outcome similar but cause death differed significantly hypoxic brain injury being leading failure patients.OHCA initially have comparable metabolic hemodynamic profiles, marked develop groups first treatment. Thus, pooling as one clinical entity should be done caution.