Universität zu Köln

Leopold, Valentine, Gayat, Etienne, Pirracchio, Romain, Spinar, Jindrich, Parenica, Jiri, Tarvasmaki, Tuukka, Lassus, Johan, Harjola, Veli-Pekka, Champion, Sebastien, Zannad, Faiez, Valente, Serafina, Urban, Philip, Chua, Horng-Ruey, Bellomo, Rinaldo, Popovic, Batric, Ouweneel, Dagmar M., Henriques, Jose P. S., Simonis, Gregor, Levy, Bruno, Kimmoun, Antoine, Gaudard, Philippe, Basir, Mir Babar, Markota, Andrej, Adler, Christoph, Reuter, Hannes, Mebazaa, Alexandre and Chouihed, Tahar (2018). Epinephrine and short-term survival in cardiogenic shock: an individual data meta-analysis of 2583 patients. Intensive Care Med., 44 (6). S. 847 - 857. NEW YORK: SPRINGER. ISSN 1432-1238

Full text not available from this repository.

Abstract

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 Fourteen published cohorts and two unpublished data sets were included.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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Leopold, Valentine UNSPECIFIED UNSPECIFIED UNSPECIFIED Gayat, Etienne UNSPECIFIED UNSPECIFIED UNSPECIFIED Pirracchio, Romain UNSPECIFIED UNSPECIFIED UNSPECIFIED Spinar, Jindrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Parenica, Jiri UNSPECIFIED UNSPECIFIED UNSPECIFIED Tarvasmaki, Tuukka UNSPECIFIED UNSPECIFIED UNSPECIFIED Lassus, Johan UNSPECIFIED UNSPECIFIED UNSPECIFIED Harjola, Veli-Pekka UNSPECIFIED UNSPECIFIED UNSPECIFIED Champion, Sebastien UNSPECIFIED UNSPECIFIED UNSPECIFIED Zannad, Faiez UNSPECIFIED UNSPECIFIED UNSPECIFIED Valente, Serafina UNSPECIFIED UNSPECIFIED UNSPECIFIED Urban, Philip UNSPECIFIED UNSPECIFIED UNSPECIFIED Chua, Horng-Ruey UNSPECIFIED UNSPECIFIED UNSPECIFIED Bellomo, Rinaldo UNSPECIFIED UNSPECIFIED UNSPECIFIED Popovic, Batric UNSPECIFIED UNSPECIFIED UNSPECIFIED Ouweneel, Dagmar M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Henriques, Jose P. S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Simonis, Gregor UNSPECIFIED UNSPECIFIED UNSPECIFIED Levy, Bruno UNSPECIFIED UNSPECIFIED UNSPECIFIED Kimmoun, Antoine UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaudard, Philippe UNSPECIFIED UNSPECIFIED UNSPECIFIED Basir, Mir Babar UNSPECIFIED UNSPECIFIED UNSPECIFIED Markota, Andrej UNSPECIFIED UNSPECIFIED UNSPECIFIED Adler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, Hannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Mebazaa, Alexandre UNSPECIFIED UNSPECIFIED UNSPECIFIED Chouihed, Tahar UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-184371
DOI:	10.1007/s00134-018-5222-9
Journal or Publication Title:	Intensive Care Med.
Volume:	44
Number:	6
Page Range:	S. 847 - 857
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1238
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE MYOCARDIAL-INFARCTION; MECHANICAL CIRCULATORY SUPPORT; INTRAAORTIC BALLOON PUMP; CARDIOPULMONARY-RESUSCITATION; CONTEMPORARY MANAGEMENT; CARDIAC-ARREST; PREDICTORS; REGISTRY; TRIAL; REVASCULARIZATION Multiple languages Critical Care Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18437