Prognostic influence of lung compliance in patients with cardiogenic shock and invasive mechanical ventilation

Background: There is limited data regarding the influence of lung compliance on the outcome of patients with cardiogenic shock (CS). Thus, a registry study was conducted to assess the prognostic influence of lung compliance in invasively ventilated patients with CS. Methods: Hospital records for con...

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Main Authors: Rusnak, Jonas (Author) , Schupp, Tobias (Author) , Weidner, Kathrin (Author) , Ruka, Marinela (Author) , Egner-Walter, Sascha (Author) , Schmitt, Alexander (Author) , Akin, Muharrem (Author) , Tajti, Péter (Author) , Mashayekhi, Kambis (Author) , Ayoub, Mohamed (Author) , Behnes, Michael (Author) , Akın, Ibrahim (Author)
Format: Article (Journal)
Language:English
Published: November 2024
In: Reviews in cardiovascular medicine
Year: 2024, Volume: 25, Issue: 11, Pages: 1-13
ISSN:2153-8174
DOI:10.31083/j.rcm2511420
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.31083/j.rcm2511420
Verlag, lizenzpflichtig, Volltext: https://www.imrpress.com/journal/RCM/25/11/10.31083/j.rcm2511420
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Author Notes:Jonas Rusnak, Tobias Schupp, Kathrin Weidner, Marinela Ruka, Sascha Egner-Walter, Alexander Schmitt, Muharrem Akin, Péter Tajti, Kambis Mashayekhi, Mohamed Ayoub, Michael Behnes, Ibrahim Akin
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Summary:Background: There is limited data regarding the influence of lung compliance on the outcome of patients with cardiogenic shock (CS). Thus, a registry study was conducted to assess the prognostic influence of lung compliance in invasively ventilated patients with CS. Methods: Hospital records for consecutive invasively ventilated CS-patients from June 2019 to May 2021 were collected into a prospective registry. Our study evaluated the prognostic influence of lung compliance on 30-day all-cause mortality. Statistical analyses comprised t-tests, analysis of variance (ANOVA), Kruskal-Wallis-tests, Spearman’s correlation, Kaplan-Meier survival analyses, and Cox regression. Results: A total of 141 patients with CS requiring invasive mechanical ventilation were included. Stratification by quartiles revealed that patients with the lowest lung compliance (≤23.8 mL/cmH2O) experienced the highest mortality rates (77.1% vs. 66.7% vs. 48.6% vs. 51.4%; log-rank p = 0.018) both overall and among the subgroup of CS-patients with cardiac arrest (80% vs. 74% vs. 53% vs. 59%; log-rank p = 0.037). After stratifying by the median, patients with lung compliance <30.4 mL/cmH2O demonstrated a significantly higher 30-day all-cause mortality compared to those above this threshold (71.8% vs. 50.0%; log-rank p = 0.007) for both the overall cohort and the cardiac arrest subgroup (77.2% vs. 55.9%; log-rank p = 0.008). Multivariable adjustment confirmed that lung compliance <30.4 mL/cmH2O was significantly associated with increased 30-day all-cause mortality in the entire cohort (hazard ratio [HR] = 1.698; 95% CI 1.085-2.659; p = 0.021). Notably, this association was not significant in CS-patients with cardiac arrest (HR = 1.523; 95% CI 0.952-2.438; p = 0.080). Additionally, those with lung compliance below the median experienced fewer ventilator-free days (p = 0.003). Conclusions: In invasively ventilated CS-patients, low lung compliance was associated with higher all-cause mortality and fewer ventilator-free days at 30 days. Clinical Trial Registration: NCT05575856, https://clinicaltrials.gov/study/NCT05575856.
Item Description:Online veröffentlicht: 22. November 2024
Gesehen am 14.04.2025
Physical Description:Online Resource
ISSN:2153-8174
DOI:10.31083/j.rcm2511420