Cardiogenic shock and infection: A lethal combination

被引：0

作者：

Cherbi, Miloud ^{[1
,2
]}

Merdji, Hamid ^{[3
]}

Labbe, Vincent ^{[4
]}

Bonnefoy, Eric ^{[5
]}

Lamblin, Nicolas ^{[6
]}

Roubille, Francois ^{[7
]}

Levy, Bruno ^{[8
]}

Lim, Pascal ^{[9
,10
]}

Khachab, Hadi ^{[11
]}

Schurtz, Guillaume ^{[7
]}

Harbaoui, Brahim ^{[12
,13
,14
]}

Vanzetto, Gerald ^{[15
]}

Combaret, Nicolas ^{[16
]}

Marchandot, Benjamin ^{[17
]}

Lattuca, Benoit ^{[18
]}

Biendel-Picquet, Caroline ^{[1
,2
]}

Leurent, Guillaume ^{[19
]}

Gerbaud, Edouard ^{[20
,21
]}

Puymirat, Etienne ^{[22
,23
]}

Bonello, Laurent ^{[24
,25
,26
]}

Delmas, Clement ^{[1
,2
]}

机构：

[1] Rangueil Univ Hosp, Intens Cardiac Care Unit, 1 Ave Jean Poulhes, F-31059 Toulouse, France

[2] Inst Metab & Cardiovasc Dis I2MC, Inserm, UMR 1048, F-31432 Toulouse, France

[3] CHU Strasbourg, Med Intens Care Unit, F-67000 Strasbourg, France

[4] Hop Tenon, Cardiol Dept, AP HP, F-75020 Paris, France

[5] Lyon Univ Hosp, Intens Cardiac Care Unit, F-69500 Bron, France

[6] Univ Lille, Urgences & Soins Intens Cardiol, CHU Lille, Inserm,U1167, F-59000 Lille, France

[7] Univ Montpellier, Cardiol Dept, CHU Montpellier, PhyMedExp,CNRS, F-34090 Montpellier, France

[8] CHRU Nancy, Reanimat Medicale Brabois, F-54511 Vand?uvre Les Nancy, France

[9] Univ Paris Est Creteil, Inserm, IMRB, F-94010 Creteil, France

[10] Hop Univ Henri Mondor, Serv Cardiol, AP HP, F-94010 Creteil, France

[11] CH Aix en Provence, Dept Cardiol, Intens Cardiac Care Unit, F-13616 Aix En Provence, France

[12] Hosp Civils Lyon, Hop Croix Rousse, Cardiol Dept, F-69004 Lyon, France

[13] Hosp Civils Lyon, Hop Lyon Sud, F-69004 Lyon, France

[14] Univ Lyon, CREATIS, Inserm, UMR 5220,U1044,INSA 15 Lyon, F-69621 Villeurbanne, France

[15] Hop Grenoble, Dept Cardiol, F-38700 La Tronche, France

[16] Univ Clermont Auvergne, Dept Cardiol, CHU Clermont Ferrand, CNRS, F-63000 Clermont Ferrand, France

[17] Univ Strasbourg, Nouvel Hop Civil, CHU, Pole Act Med Chirurgicale Cardiovasc, F-67091 Strasbourg, France

[18] Montpellier Univ, Nimes Univ Hosp, Dept Cardiol, F-30900 Nimes, France

[19] Univ Rennes 1, Dept Cardiol, CHU Rennes, Inserm,LTSI,UMR 1099, F-35000 Rennes, France

[20] Hop Cardiol Haut Leveque, Intens Cardiac Care Unit & Intervent Cardiol, F-33604 Pessac, France

[21] Bordeaux Univ, Hop Xavier Arnozan, Bordeaux Cardiothorac Res Ctr, U1045, F-33600 Pessac, France

[22] Hop Europeen Georges Pompidou, Dept Cardiol, AP HP, F-75015 Paris, France

[23] Univ Paris, F-75006 Paris, France

[24] Aix Marseille Univ, F-13385 Marseille, France

[25] Hop Nord Marseille, Dept Cardiol, Intens Care Unit, AP HM, F-13385 Marseille, France

[26] Mediterranean Assoc Res & Studies Cardiol MARS Car, F-13015 Marseille, France

来源：

ARCHIVES OF CARDIOVASCULAR DISEASES | 2024年 / 117卷 / 8-9期

关键词：

Cardiogenic shock; Sepsis; Epidemiology; Prognosis; Mortality; ACUTE ORGAN DYSFUNCTION; SEPTIC SHOCK; SEPSIS; CLASSIFICATION; COMPLICATIONS;

D O I：

10.1016/j.acvd.2024.04.005

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Cardiogenic shock and sepsis are severe haemodynamic states that are frequently present concomitantly, leading to substantial mortality. Despite its frequency and clinical significance, there is a striking lack of literature on the outcomes of combined sepsis and cardiogenic shock. Methods: FRENSHOCK was a prospective registry including 772 patients with cardiogenic shock from 49 centres. The primary endpoint was 1-month all-cause mortality. Secondary endpoints included heart transplantation, ventricular assistance device and all-cause death rate at 1 year. Results: Among the 772 patients with cardiogenic shock included, 92 cases were triggered by sepsis (11.9%), displaying more frequent renal and hepatic acute injuries, with lower mean arterial pressure. Patients in the sepsis group required broader use of dobutamine (90.1% vs. 81.2%; P = 0.16), norepinephrine (72.5% vs. 50.8%; P < 0.01), renal replacement therapy (29.7% vs. 14%; P < 0.01), non-invasive ventilation (36.3% vs. 24.4%; P = 0.09) and invasive ventilation (52.7% vs. 35.9%; P = 0.02). Sepsis-triggered cardiogenic shock resulted in higher 1-month (41.3% vs. 24.0%; adjusted hazard ratio: 1.94, 95% confidence interval: 1.36-2.76; P < 0.01) and 1-year (62.0% vs. 42.9%; adjusted hazard ratio 1.75, 95% confidence interval 1.32-2.33; P < 0.01) all-cause death rates. No significant difference was found at 1 year for heart transplantation or ventricular assistance device (8.7% vs. 10.3%; adjusted odds ratio 0.72, 95% confidence interval 0.32-1.64; P = 0.43). In patients with sepsis-triggered cardiogenic shock, neither the presence of a preexisting cardiomyopathy nor the co-occurrence of other cardiogenic shock triggers had any additional impact on death. Conclusions: The association between sepsis and cardiogenic shock represents a common high-risk scenario, leading to higher short- and long-term death rates, regardless of the association with other cardiogenic shock triggers or the presence of preexisting cardiomyopathy.

引用

页码：470 / 479

页数：10

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