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Master thesis

Pronostic et prise en charge du choc cardiogénique non ischémique en réanimation médicale

Abstract : Background : Epidemiological studies published about cardiogenic shock focus on shocks complicating acute coronary syndromes. No study described the characteristics and prognosis of cardiogenic shocks of non?ischemic etiology.Method : We analyzed retrospectively the medical files of patients admitted for non ischemic cardiogenic shock between January 1st 2007 and December 31st 2009 in the medical intensive care unit (ICU) of Brabois university hospital of Nancy.Results : 94 patients were admitted for this diagnosis during this period. The most frequent causes were decompensated cardiomyopathy (50 %), resuscitated cardiac arrest (26 %), endocarditis (8,5 %) or myocarditis (4 %). Survival in ICU, hospital, at 28 days and one year were 53 %, 47 %, 43 % et 32 % respectively. Compared with ICU non survivors, ICU survivors were younger (57 versus 64 years, p = 0,023), had a lower IGSII score on admission and maximum lactate concentration (53 versus 74, p < 0,0001 and 4,1 mmol/L versus 7,2 mmol/L, p = 0,001 respectively). Hemodynamic monitoring data were comparable beteen the two groups on admission. At 24 hours, survivors had higher cardiac power index and diastolic and mean arterial pressure (p < 0,05).Conclusion : Non ischemic cardiogenic shock is a pathology burdened with a very severe prognosis but a prolonged survival is observed in a third of patients. Hemodynamic data on admission can't predict ulterior evolution. ICU survivors haved a better response to treatment, appreciated by cardiac power index and diastolic and mean arterial pressure at 24 hours.
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https://hal.univ-lorraine.fr/hal-01733621
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  • HAL Id : hal-01733621, version 1

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Sylvain Jean-Baptiste. Pronostic et prise en charge du choc cardiogénique non ischémique en réanimation médicale. Sciences du Vivant [q-bio]. 2011. ⟨hal-01733621⟩

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