Acute Myocardial Infarction Complicated by Cardiogenic Shock
Conditions
Interventions
experimental group:PiCCO
control group:Deep venipuncture monitors central venous pressure
Sponsors
General Hospital of Chinese People's Liberation Army
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Inclusion criteria
Inclusion criteria: The study was approved and monitored by the Institutional Review Board of the PLA General Hospital, Beijing, China. Patients, who were admitted to the emergency intensive care unit (EICU) or coronary care unit (CCU), were recruited if they met the following criteria: over 65 years of age and presence of cardiogenic shock, consequent to AMI. AMI was diagnosed as follows: 1) an increase in cardiac troponin I (cTnI) or creatine kinase-MB (CK-MB) levels above the 99th percentile of a healthy; 2) characteristic ECG changes- either ST segment elevation, new ST segment depression or T wave flattening, inversion; and, 3) at least one of the following signs or symptoms: (a) persistent ischemic chest pain; (b) echocardiographic findings-segmental wall motion abnormalities; (c) abnormal coronary angiography findings. Cardiogenic shock was diagnosed on the basis of the following criteria: 1) objective evidence of cardiac dysfunction; 2) systolic blood pressure <90 mmHg for at least 30 min or vasopressors required to maintain the systolic blood pressure =90 mmHg; 3) a reduced cardiac index (<2.2 L/min/m2); and, 4) clinical signs of tissue hypoperfusion (cold, clammy skin, altered mental status, oliguria or peripheral vasoconstriction).
Exclusion criteria
Exclusion criteria: Exclusion criteria included the following: viral myocarditis, pericardial tamponade, cardiogenic shock due to chronic heart failure and congenital heart disease, malignant tumor, septic shock and multiple organ dysfunction syndrome (MODS), are moribund, or informed consent cannot be obtained; contraindications to catheter insertion, including overlying infection and arterial grafting; conditions likely to render PiCCO measurements inaccurate, including intracardiac shunts, significant tricuspid regurgitation, and cooling or rewarming Written informed consent form was signed by family members of the patients.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, high-sensitive Troponin I (hs-TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), PaO2/FiO2 ratio and lactate levels;?????;The visceral index(CI), extravascular lung water index(EVLWI), intrathoracic blood volume Index(ITBVI), total end diastolic volume index(GEDVI);activities of daily living (ADL) score, the days on vasoactive agents, days on mechanical ventilation, duration of mechanical ventilation, EICU/CCU length of stay and occurrence of pulmonary edema; | — |
Countries
China
Contacts
Public ContactZhang Yuanbo
7th Medical Center, General Hospital of Chinese People's Liberation Army
Outcome results
None listed