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Diagnosis of cardiogenic shock without the use of a pulmonary artery catheter

Cooper, Howard A ; Najafi, Amir H ; Ghafourian, Kambiz ; Paixao, Andre RM ; Aljaabari, Mohamed ; Iantorno, Micaela ; Caños, Daniel ; Asch, Federico M ; Panza, Julio A

European heart journal. Acute cardiovascular care, 2015-02, Vol.4 (1), p.88-95 [Periódico revisado por pares]

London, England: SAGE Publications

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  • Título:
    Diagnosis of cardiogenic shock without the use of a pulmonary artery catheter
  • Autor: Cooper, Howard A ; Najafi, Amir H ; Ghafourian, Kambiz ; Paixao, Andre RM ; Aljaabari, Mohamed ; Iantorno, Micaela ; Caños, Daniel ; Asch, Federico M ; Panza, Julio A
  • Assuntos: Aged ; Feasibility Studies ; Female ; Hemodynamics - physiology ; Humans ; Male ; Prospective Studies ; Retrospective Studies ; Shock, Cardiogenic - diagnosis ; Shock, Cardiogenic - physiopathology
  • É parte de: European heart journal. Acute cardiovascular care, 2015-02, Vol.4 (1), p.88-95
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: Background: Current diagnostic criteria for cardiogenic shock (CS) require the use of a pulmonary artery catheter (PAC), which is time-consuming and may cause complications. A set of simple yet accurate noninvasive diagnostic criteria would be of significant utility. Methods: Candidate components for the Noninvasive Parameters for Assessment of Cardiogenic Shock (N-PACS) criteria were required to be objective, readily available, and noninvasive. Variables encompassing hypotension, hypoperfusion, predisposing conditions, and elevated intracardiac filling pressures were optimized versus a PAC-based standard in a retrospective developmental cohort of 122 patients with acute myocardial infarction (AMI). The finalized criteria were validated in a prospective cohort of coronary care unit patients in whom a PAC was placed for clinical indications. Results: According to invasive criteria, CS was present in 32 of 217 consecutive patients undergoing PAC. Compared to the PAC-based standard, the N-PACS criteria had a sensitivity of 96.9% (95% confidence interval (CI) 82.0–99.8), specificity of 90.8% (95% CI 85.5–94.4), positive predictive value of 64.6% (95% CI 49.4–77.4), negative predictive value of 99.4% (95% CI 96.2–100), positive likelihood ratio of 10.5 (95% CI 6.7–16.7), negative likelihood ratio of 0.03 (95% CI 0.00–0.24), and diagnostic odds ratio of 306.4. Results were similar among patients with and without AMI. Conclusion: A simple, echocardiography-based set of noninvasive diagnostic criteria can be used to accurately diagnose CS.
  • Editor: London, England: SAGE Publications
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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