J 2018

Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients

LEOPOLD, Valentine; Etienne GAYAT; Romain PIRRACCHIO; Jindřich ŠPINAR; Jiří PAŘENICA et al.

Základní údaje

Originální název

Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients

Autoři

LEOPOLD, Valentine; Etienne GAYAT; Romain PIRRACCHIO; Jindřich ŠPINAR; Jiří PAŘENICA; Tuukka TARVASMAKI; Johan LASSUS; Veli-Pekka HARJOLA; Sebastien CHAMPION; Faiez ZANNAD; Serafina VALENTE; Philip URBAN; Horng-Ruey CHUA; Rinaldo BELLOMO; Batric POPOVIC; Dagmar M. OUWENEEL; Jose P. S. HENRIQUES; Gregor SIMONIS; Bruno LEVY; Antoine KIMMOUN; Philippe GAUDARD; Mir Babar BASIR; Andrej MARKOTA; Christoph ADLER; Hannes REUTER; Alexandre MEBAZAA a Tahar CHOUIHED

Vydání

Intensive care medicine, NEW YORK, SPRINGER, 2018, 0342-4642

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 18.967

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/18:00104160

Organizační jednotka

Lékařská fakulta

EID Scopus

Klíčová slova anglicky

Meta-analysis; Cardiogenic shock; Epinephrine; Prognosis

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 9. 2. 2019 22:48, Soňa Böhmová

Anotace

V originále

Catecholamines have been the mainstay of pharmacological treatment of cardiogenic shock (CS). Recently, use of epinephrine has been associated with detrimental outcomes. In the present study we aimed to evaluate the association between epinephrine use and short-term mortality in all-cause CS patients. We performed a meta-analysis of individual data with prespecified inclusion criteria: (1) patients in non-surgical CS treated with inotropes and/or vasopressors and (2) at least 15% of patients treated with epinephrine administrated alone or in association with other inotropes/vasopressors. The primary outcome was short-term mortality. Fourteen published cohorts and two unpublished data sets were included. We studied 2583 patients. Across all cohorts of patients, the incidence of epinephrine use was 37% (17-76%) and short-term mortality rate was 49% (21-69%). A positive correlation was found between percentages of epinephrine use and short-term mortality in the CS cohort. The risk of death was higher in epinephrine-treated CS patients (OR [CI] = 3.3 [2.8-3.9]) compared to patients treated with other drug regimens. Adjusted mortality risk remained striking in epinephrine-treated patients (n = 1227) (adjusted OR = 4.7 [3.4-6.4]). After propensity score matching, two sets of 338 matched patients were identified and epinephrine use remained associated with a strong detrimental impact on short-term mortality (OR = 4.2 [3.0-6.0]). In this very large cohort, epinephrine use for hemodynamic management of CS patients is associated with a threefold increase of risk of death.