Ventilation strategies in cardiogenic shock: insights from the FRENSHOCK observational registry.

Cardiogenic shock Mechanical ventilation Mortality Non-invasive ventilation Prognosis

Journal

Clinical research in cardiology : official journal of the German Cardiac Society

ISSN: 1861-0692

Titre abrégé: Clin Res Cardiol

Pays: Germany

ID NLM: 101264123

Informations de publication

Date de publication:
23 Oct 2024

Historique:

received: 06 02 2024

accepted: 20 09 2024

medline: 23 10 2024

pubmed: 23 10 2024

entrez: 23 10 2024

Statut: aheadofprint

Résumé

Despite scarce data, invasive mechanical ventilation (MV) is widely suggested as first-line ventilatory support in cardiogenic shock (CS) patients. We assessed the real-life use of different ventilation strategies in CS and their influence on short and mid-term prognosis. FRENSHOCK was a prospective registry including 772 CS patients from 49 centers in France. Patients were categorized into three groups according to the ventilatory supports during hospitalization: no mechanical ventilation group (NV), non-invasive ventilation alone group (NIV), and invasive mechanical ventilation group (MV). We compared clinical characteristics, management, and occurrence of death and major adverse event (MAE) (death, heart transplantation or ventricular assist device) at 30 days and 1 year between the three groups. Seven hundred sixty-eight patients were included in this analysis. Mean age was 66 years and 71% were men. Among them, 359 did not receive any ventilatory support (46.7%), 118 only NIV (15.4%), and 291 MV (37.9%). MV patients presented more severe CS with more skin mottling, higher lactate levels, and higher use of vasoactive drugs and mechanical circulatory support. MV was associated with higher mortality and MAE at 30 days (HR 1.41 [1.05-1.90] and 1.52 [1.16-1.99] vs NV). No difference in mortality (HR 0.79 [0.49-1.26]) or MAE (HR 0.83 [0.54-1.27]) was found between NIV patients and NV patients. Similar results were found at 1-year follow-up. Our study suggests that using NIV is safe in selected patients with less profound CS and no other MV indication. NCT02703038.

Sections du résumé

BACKGROUND BACKGROUND

METHODS METHODS

FRENSHOCK was a prospective registry including 772 CS patients from 49 centers in France. Patients were categorized into three groups according to the ventilatory supports during hospitalization: no mechanical ventilation group (NV), non-invasive ventilation alone group (NIV), and invasive mechanical ventilation group (MV). We compared clinical characteristics, management, and occurrence of death and major adverse event (MAE) (death, heart transplantation or ventricular assist device) at 30 days and 1 year between the three groups.

RESULTS RESULTS

Seven hundred sixty-eight patients were included in this analysis. Mean age was 66 years and 71% were men. Among them, 359 did not receive any ventilatory support (46.7%), 118 only NIV (15.4%), and 291 MV (37.9%). MV patients presented more severe CS with more skin mottling, higher lactate levels, and higher use of vasoactive drugs and mechanical circulatory support. MV was associated with higher mortality and MAE at 30 days (HR 1.41 [1.05-1.90] and 1.52 [1.16-1.99] vs NV). No difference in mortality (HR 0.79 [0.49-1.26]) or MAE (HR 0.83 [0.54-1.27]) was found between NIV patients and NV patients. Similar results were found at 1-year follow-up.

CONCLUSIONS CONCLUSIONS

Our study suggests that using NIV is safe in selected patients with less profound CS and no other MV indication. NCT02703038.

Identifiants

DOI: 10.1007/s00392-024-02551-x PMID: 39441346

pubmed: 39441346

doi: 10.1007/s00392-024-02551-x

pii: 10.1007/s00392-024-02551-x

doi:

Banques de données

ClinicalTrials.gov

['NCT02703038']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Investigateurs

N Aissaoui (N)

F Bagate (F)

M Beuzelin (M)

C Biendel (C)

F Boissier (F)

L Bonello (L)

E Bonnefoy-Cudraz (E)

M Boughenou (M)

S Boule (S)

J Bourenne (J)

N Brechot (N)

C Bruel (C)

A Cariou (A)

P Castellant (P)

S Champion (S)

K Chaoui (K)

M Chatot (M)

N Combaret (N)

N Debry (N)

X Delabranche (X)

C Delmas (C)

J Dib (J)

R Favory (R)

E Filippi (E)

R Gallet (R)

F Ganster (F)

P Gaudard (P)

E Gerbaud (E)

B Harbaoui (B)

P Henry (P)

B Herce (B)

F Ivanes (F)

J Joffre (J)

P Karoubi (P)

H Khachab (H)

K Khalif (K)

K Klouche (K)

V Labbe (V)

M Laine (M)

N Lamblin (N)

B Lattuca (B)

Y Lefetz (Y)

G Lemesle (G)

P Letocart (P)

G Leurent (G)

B Levy (B)

G Louis (G)

J Maizel (J)

J Mansourati (J)

S Manzo-Silberman (S)

S Marchand (S)

B Marchandot (B)

S Marliere (S)

J Mootien (J)

F Mouquet (F)

L Niquet (L)

A Paternot (A)

V Probst (V)

E Puymirat (E)

C Quentin (C)

G Range (G)

N Redjimi (N)

J Richard (J)

F Roubille (F)

C Saint Etienne (C)

F Schneider (F)

G Schurtz (G)

M Seronde (M)

J Ternacle (J)

G Vanzetto (G)

E Zogheib (E)

Informations de copyright

Références

Van Diepen S, Katz JN, Albert NM, Henry TD, Jacobs AK, Kapur NK (2017) Contemporary management of cardiogenic shock: a scientific statement from the american heart association. Circulation 136(16):e232–e268

pubmed: 28923988

Chioncel O, Parissis J, Mebazaa A, Thiele H, Desch S, Bauersachs J (2020) Epidemiology, pathophysiology and contemporary management of cardiogenic shock- a position statement from the heart failure association of the european society of cardiology. Eur J Heart Fail 22(8):1315–1341

doi: 10.1002/ejhf.1922 pubmed: 32469155

Zeymer U, Vogt A, Zahn R, Weber MA, Tebbe U, Gottwik M (2004) Predictors of in-hospital mortality in 1333 patients with acute myocardial infarction complicated by cardiogenic shock treated with primary percutaneous coronary intervention (PCI): results of the primary PCI registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausarzte (ALKK). Eur Heart J 25(4):322–328

doi: 10.1016/j.ehj.2003.12.008 pubmed: 14984921

Jeger RV, Radovanovic D, Hunziker PR, Pfisterer ME, Stauffer JC, Erne P (2008) Ten-year trends in the incidence and treatment of cardiogenic shock. Ann Intern Med 149:618–626

doi: 10.7326/0003-4819-149-9-200811040-00005 pubmed: 18981487

Delmas C, Roubille F, Lamblin N, Bonello L, Leurent G, Levy B (2022) Baseline characteristics, management, and predictors of early mortality in cardiogenic shock: insights from the FRENSHOCK registry. ESC Heart Fail 9(1):408–419

doi: 10.1002/ehf2.13734 pubmed: 34973047

Aissaoui N, Puymirat E, Delmas C, Ortuno S, Durand S, Bataille V (2020) Trends in cardiogenic shock complicating acute myocardial infarction. Eur J Heart Failure 22(4):664–672

doi: 10.1002/ejhf.1750

Aissaoui N, Puymirat E, Tabone X, Charbonnier B, Schiele F, Lefevre T (2012) Improved outcome of cardiogenic shock at the acute stage of myocardial infarction: a report from the USIK 1995, USIC 2000, and FAST-MI French nationwide registries. Eur Heart J 33:2535–2543

doi: 10.1093/eurheartj/ehs264 pubmed: 22927559

Vallabhajosyula S, Kashani K, Dunlay S, Vallabhajosyula S, Vallabhajosuyla S, Sundaragiri P (2019) Acute respiratory failure and mechanical ventilation in cardiogenic shock complicating acute myocardial infarction in the USA, 2000–2014. Ann Intensive Care 9(1):96

doi: 10.1186/s13613-019-0571-2 pubmed: 31463598 pmcid: 6713772

Werdan K, Russ M, Buerke M, Delle-Karth G, Geppert A, Schondube FA (2012) Cardiogenic shock due to myocardial infarction: diagnosis, monitoring and treatment: a german-austrian S3 guideline. Dtsch Arztebl Int 109:343–351

pubmed: 22675405 pmcid: 3364528

Keenan S, Sinuff T, Burns K, Muscedere J, Kutsogiannis J, Sangeeta M (2011) Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ 183(3):E195-214

doi: 10.1503/cmaj.100071 pubmed: 21324867 pmcid: 3042478

Masip J, Peacock F, Price S, Cullen L, Martin-Sanchez J, Seferovic P (2018) Indications and practical approach to non-invasive ventilation in acute heart failure. Eur Heart J 39(1):17–25

doi: 10.1093/eurheartj/ehx580 pubmed: 29186485

Zyemer U, Bueno H, Granger C, Hochman J, Huber K, Lettino M (2020) Acute cardiovascular care association position statement for the diagnosis and treatment of patients with acute myocardial infarction complicated by cardiogenic shock: a document of the acute cardiovascular care association of the european society of cardiology. Eur Heart J Acute Cardiovasc Care 9(2):183–197

doi: 10.1177/2048872619894254

Mac Donagh TA, Metra M, Adamo M, Gardner R, Baumbach A, Böhm M (2022) 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the heart failure association (HFA) of the ESC. Eur J Heart Fail 24(1):4–131

doi: 10.1002/ejhf.2333

Hongisto M, Lassus J, Tarvasmaki T, Sionis A, Tolppanen H, Greve LM (2017) Use of noninvasive and invasive mechanical ventilation in cardiogenic shock: A prospective multicenter study. Int J Cardiol 1(230):191–197

doi: 10.1016/j.ijcard.2016.12.175

Masip J, Betbese AJ, Paez J, Vecilla F, Canizares F, Padro J (2000) Non-invasive pressure support ventilation versus conventional oxygen therapy in acute cardiogenic pulmonary oedema: a randomised trial. Lancet 356(9248):2126–2132

doi: 10.1016/S0140-6736(00)03492-9 pubmed: 11191538

Park M, Sangean MC, Volpe MS, Feltrim M, Nozawa E, Leite P (2004) Randomized, prospective trial of oxygen, continuous positive airway pressure, and bilevel positive airway pressure by face mask in acute cardiogenic pulmonary edema. Crit Care Med 32(12):2407–2415

doi: 10.1097/01.CCM.0000147770.20400.10 pubmed: 15599144

Vital FM, Ladeira MT, Atallah AN (2013) Non-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD005351.pub3

doi: 10.1002/14651858.CD005351.pub3 pubmed: 23728654

Gimenez M, Miller P, Alviar C, Diepen S, Granger C, Montalescot G (2020) Outcomes associated with respiratory failure for patients with cardiogenic shock and acute myocardial infarction: a substudy of the CULPRIT-SHOCK trial. J Clin Med 9(3):860

doi: 10.3390/jcm9030860

Van Diepen S, Hochman J, Stebbins A, Alviar C, Alexander J, Lopes R (2020) Association between delays in mechanical ventilation initiation and mortality in patients with refractory cardiogenic shock. JAMA Cardiol 5(8):965–967

doi: 10.1001/jamacardio.2020.1274 pubmed: 32432650 pmcid: 7240630

Delmas C, Puymirat E, Leurent G, Elbaz M, Manzo-Silberman S, Bonello L, Gerbaud E, Bataille V, Levy B, Lamblin N et al (2019) Design and preliminary results of FRENSHOCK 2016: a prospective nationwide multicentre registry on cardiogenic shock. Arch Cardiovasc Dis 112(5):343–353

doi: 10.1016/j.acvd.2019.02.001 pubmed: 30982720

Darreau C, Martino F, Saint-Martin M et al (2020) Use, timing and factors associated with tracheal intubation in septic shock: a prospective multicentric observational study. Ann Intensive Care 10:62

doi: 10.1186/s13613-020-00668-6 pubmed: 32449053 pmcid: 7245631

Alviar CL, Miller PE, McAreavey D, Katz JN, Lee B, Moriyama B et al (2018) Positive pressure ventilation in the cardiac intensive care unit. J Am Coll Cardiol 72:1532–1553

doi: 10.1016/j.jacc.2018.06.074 pubmed: 30236315 pmcid: 11032173

Girou E, Schortgen F, Delclaux C, Brun-Buisson C, Blot F, Lefort Y (2000) Association of noninvasive ventilation with nosocomial infections and survival in critically ill patients. JAMA 284(18):2361–2367

doi: 10.1001/jama.284.18.2361 pubmed: 11066187

Mort TC (2007) Complications of emergency tracheal intubation: hemodynamic alterations–part I. J Intensive Care Med 22(3):157–165

doi: 10.1177/0885066607299525 pubmed: 17562739

Alviar CL, Rico-Mesa JS, Morrow DA et al (2020) Positive pressure ventilation in cardiogenic shock: review of the evidence and practical advice for patients with mechanical circulatory support. Can J Cardiol 36:300–312

doi: 10.1016/j.cjca.2019.11.038 pubmed: 32036870