Infectious complications and immune/inflammatory response in
cardiogenic shock patients: A prospective observational study

J 2017

Infectious complications and immune/inflammatory response in cardiogenic shock patients: A prospective observational study

PAŘENICA, Jiří, Jiří JARKOVSKÝ, Jan MALÁSKA, Alexandre MEBAZAA, Jana GOTTWALDOVÁ et. al.

Basic information

Original name

Infectious complications and immune/inflammatory response in cardiogenic shock patients: A prospective observational study

Authors

PAŘENICA, Jiří (203 Czech Republic, guarantor, belonging to the institution), Jiří JARKOVSKÝ (203 Czech Republic, belonging to the institution), Jan MALÁSKA (203 Czech Republic, belonging to the institution), Alexandre MEBAZAA (250 France), Jana GOTTWALDOVÁ (203 Czech Republic, belonging to the institution), Kateřina HELÁNOVÁ (203 Czech Republic), Jiří LITZMAN (203 Czech Republic, belonging to the institution), Milan DASTYCH (203 Czech Republic, belonging to the institution), Josef TOMANDL (203 Czech Republic, belonging to the institution), Jindřich ŠPINAR (203 Czech Republic, belonging to the institution), Ludmila DOSTÁLOVÁ (203 Czech Republic, belonging to the institution), Petr LOKAJ (203 Czech Republic, belonging to the institution), Marie TOMANDLOVÁ (203 Czech Republic, belonging to the institution), Monika PÁVKOVÁ GOLDBERGOVÁ (203 Czech Republic, belonging to the institution), Pavel ŠEVČÍK (203 Czech Republic) and Matthieu LEGRAND (250 France)

Edition

Shock, Philadelphia, Lippincott Williams & Wilkins, 2017, 1073-2322

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.005

RIV identification code

RIV/00216224:14110/17:00096765

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1097/SHK.0000000000000756

UT WoS

000392813300007

Keywords in English

Cardiogenic shock; C-reactive protein; infection; inflammatory response; pentraxin 3; presepsin; procalcitonin

Abstract

V originále

Introduction: Patients with cardiogenic shock (CS) are at a high risk of developing infectious complications; however, their early detection is difficult, mainly due to a frequently occurring noninfectious inflammatory response, which accompanies an extensivemyocardial infarction (MI) or a postcardiac arrest syndrome. The goal of our prospective study was to describe infectious complications in CS and the immune/inflammatory response based on a serial measurement of several blood-based inflammatory biomarkers. Methods: Eighty patients with CS were evaluated and their infections were monitored. Inflammatory markers (C-reactive protein, procalcitonin, pentraxin 3, presepsin) were measured seven times per week. The control groups consisted of 11 patients with ST segment elevation myocardial infarction without CS and without infection, and 22 patients in septic shock. Results: Infection was diagnosed in 46.3% of patients with CS; 16 patients developed an infection within 48 h. Respiratory infection was most common, occurring in 33 out of 37 patients. Infection was a significant or even the main reason of death only in 3.8% of all patients with CS, and we did not find statistically significant difference in 3-month mortality between group of patients with CS with and without infection. There was no statistically significant prolongation of the duration of mechanical ventilation associated with infection. Strong inflammatory response is often in patientswith CS due to MI, but we found no significant difference in the course of the inflammatory response expressed by evaluated biomarkers in patients with CS with and without infection. We found a strong relationship between the elevated inflammatory markers (sampled at 12 h) and the 3-month mortality: the area under the curve of receiver operating characteristic ranged between 0.683 and 0.875. Conclusion: The prevalence of infection in patients with CS was 46.3%, and respiratory tract infections were the most common type. Infections did not prolong statistically significantly the duration of mechanical ventilation and did not increase the prevalence of hospital mortality in this high-risk CS population. CS due to acute myocardial infarction was accompanied by a strong and highly variable inflammatory response, but it did not reach the intensity of the inflammatory response observed in patients with septic shock. An extensive immune/inflammatory response in patients with CS is linked to a poor prognosis.

Links

MUNI/A/1362/2015, interní kód MU

Name: Neurohumorální profil a prognóza pacientů s chronickým srdečním selháním

Investor: Masaryk University, Category A

Citovat

PAŘENICA, Jiří, Jiří JARKOVSKÝ, Jan MALÁSKA, Alexandre MEBAZAA, Jana GOTTWALDOVÁ, Kateřina HELÁNOVÁ, Jiří LITZMAN, Milan DASTYCH, Josef TOMANDL, Jindřich ŠPINAR, Ludmila DOSTÁLOVÁ, Petr LOKAJ, Marie TOMANDLOVÁ, Monika PÁVKOVÁ GOLDBERGOVÁ, Pavel ŠEVČÍK and Matthieu LEGRAND. Infectious complications and immune/inflammatory response in cardiogenic shock patients: A prospective observational study. Shock. Philadelphia: Lippincott Williams & Wilkins, 2017, vol. 47, No 2, p. 165-174. ISSN 1073-2322. Available from: https://dx.doi.org/10.1097/SHK.0000000000000756.

@article{1381316,
   author = {Pařenica, Jiří and Jarkovský, Jiří and Maláska, Jan and Mebazaa, Alexandre and Gottwaldová, Jana and Helánová, Kateřina and Litzman, Jiří and Dastych, Milan and Tomandl, Josef and Špinar, Jindřich and Dostálová, Ludmila and Lokaj, Petr and Tomandlová, Marie and Pávková Goldbergová, Monika and Ševčík, Pavel and Legrand, Matthieu},
   article_location = {Philadelphia},
   article_number = {2},
   doi = {http://dx.doi.org/10.1097/SHK.0000000000000756},
   keywords = {Cardiogenic shock; C-reactive protein; infection; inflammatory response; pentraxin 3; presepsin; procalcitonin},
   language = {eng},
   issn = {1073-2322},
   journal = {Shock},
   title = {Infectious complications and immune/inflammatory response in cardiogenic shock patients: A prospective observational study},
   volume = {47},
   year = {2017}
}

TY  - JOUR
ID  - 1381316
AU  - Pařenica, Jiří - Jarkovský, Jiří - Maláska, Jan - Mebazaa, Alexandre - Gottwaldová, Jana - Helánová, Kateřina - Litzman, Jiří - Dastych, Milan - Tomandl, Josef - Špinar, Jindřich - Dostálová, Ludmila - Lokaj, Petr - Tomandlová, Marie - Pávková Goldbergová, Monika - Ševčík, Pavel - Legrand, Matthieu
PY  - 2017
TI  - Infectious complications and immune/inflammatory response in cardiogenic shock patients: A prospective observational study
JF  - Shock
VL  - 47
IS  - 2
SP  - 165-174
EP  - 165-174
PB  - Lippincott Williams & Wilkins
SN  - 10732322
KW  - Cardiogenic shock
KW  - C-reactive protein
KW  - infection
KW  - inflammatory response
KW  - pentraxin 3
KW  - presepsin
KW  - procalcitonin
N2  - Introduction: Patients with cardiogenic shock (CS) are at a high risk of developing infectious complications; however, their early detection is difficult, mainly due to a frequently occurring noninfectious inflammatory response, which accompanies an extensivemyocardial infarction (MI) or a postcardiac arrest syndrome. The goal of our prospective study was to describe infectious complications in CS and the immune/inflammatory response based on a serial measurement of several blood-based inflammatory biomarkers. Methods: Eighty patients with CS were evaluated and their infections were monitored. Inflammatory markers (C-reactive protein, procalcitonin, pentraxin 3, presepsin) were measured seven times per week. The control groups consisted of 11 patients with ST segment elevation myocardial infarction without CS and without infection, and 22 patients in septic shock. Results: Infection was diagnosed in 46.3% of patients with CS; 16 patients developed an infection within 48 h. Respiratory infection was most common, occurring in 33 out of 37 patients. Infection was a significant or even the main reason of death only in 3.8% of all patients with CS, and we did not find statistically significant difference in 3-month mortality between group of patients with CS with and without infection. There was no statistically significant prolongation of the duration of mechanical ventilation associated with infection. Strong inflammatory response is often in patientswith CS due to MI, but we found no significant difference in the course of the inflammatory response expressed by evaluated biomarkers in patients with CS with and without infection. We found a strong relationship between the elevated inflammatory markers (sampled at 12 h) and the 3-month mortality: the area under the curve of receiver operating characteristic ranged between 0.683 and 0.875. Conclusion: The prevalence of infection in patients with CS was 46.3%, and respiratory tract infections were the most common type. Infections did not prolong statistically significantly the duration of mechanical ventilation and did not increase the prevalence of hospital mortality in this high-risk CS population. CS due to acute myocardial infarction was accompanied by a strong and highly variable inflammatory response, but it did not reach the intensity of the inflammatory response observed in patients with septic shock. An extensive immune/inflammatory response in patients with CS is linked to a poor prognosis.
ER  -

PAŘENICA, Jiří, Jiří JARKOVSKÝ, Jan MALÁSKA, Alexandre MEBAZAA, Jana GOTTWALDOVÁ, Kateřina HELÁNOVÁ, Jiří LITZMAN, Milan DASTYCH, Josef TOMANDL, Jindřich ŠPINAR, Ludmila DOSTÁLOVÁ, Petr LOKAJ, Marie TOMANDLOVÁ, Monika PÁVKOVÁ GOLDBERGOVÁ, Pavel ŠEVČÍK and Matthieu LEGRAND. Infectious complications and immune/inflammatory response in cardiogenic shock patients: A prospective observational study. \textit{Shock}. Philadelphia: Lippincott Williams \&{} Wilkins, 2017, vol.~47, No~2, p.~165-174. ISSN~1073-2322. Available from: https://dx.doi.org/10.1097/SHK.0000000000000756.

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