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 (250 Francie), Etienne GAYAT (250 Francie), Romain PIRRACCHIO (250 Francie), Jindřich ŠPINAR (203 Česká republika, domácí), Jiří PAŘENICA (203 Česká republika, domácí), Tuukka TARVASMAKI (246 Finsko), Johan LASSUS (246 Finsko), Veli-Pekka HARJOLA (246 Finsko), Sebastien CHAMPION (250 Francie), Faiez ZANNAD (250 Francie), Serafina VALENTE (380 Itálie), Philip URBAN (756 Švýcarsko), Horng-Ruey CHUA (36 Austrálie), Rinaldo BELLOMO (36 Austrálie), Batric POPOVIC (250 Francie), Dagmar M. OUWENEEL (528 Nizozemské království), Jose P. S. HENRIQUES (528 Nizozemské království), Gregor SIMONIS (276 Německo), Bruno LEVY (250 Francie), Antoine KIMMOUN (250 Francie), Philippe GAUDARD (250 Francie), Mir Babar BASIR (840 Spojené státy), Andrej MARKOTA (705 Slovinsko), Christoph ADLER (276 Německo), Hannes REUTER (276 Německo), Alexandre MEBAZAA (250 Francie, garant) a Tahar CHOUIHED (250 Francie)

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

Kód RIV

RIV/00216224:14110/18:00104160

Organizační jednotka

Lékařská fakulta

UT WoS

000435995400012

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.