Hemodynamics, fluids & transfusion
Effect of pulmonary artery catheter, type & combination of vasoactives for optimizing lactate clearance in acute myocardial infarction complicated by cardiogenic shock
Authors' conclusion
The right combination of vasoactive medications and the probable use of a PAC could significantly impact the achievement of complete LC in <96 h.
Study context
- Population
- Patients with AMI complicated by cardiogenic shock (AMI-CS)
- Participants
- 651 patients
- Exposure
- Pulmonary artery catheter (PAC) presence and vasoactive drug type/combination in relation to lactate clearance
- Outcome
- Lactate clearance time (complete LC: serum lactate <2 mmol/L)
Methodological detailsCART analysis
- CART analysis
Main finding
As reported in the abstract
Lactate clearance time
PAC presence correlated with faster lactate clearance (LC)
−17.54 h
Levosimendan associated with lower lactate levels and faster LC
−8.82 h
Dobutamine associated with lower lactate levels and faster LC
−8.77 h
Vasopressin linked to slower LC
9.16 h
Observational data: associations, not effects.
Further findings
Mortality by vasoactive combination (CART)
HR 5.53
| Outcome | HR |
|---|---|
| Mortality, PAC presenceIndependently associated with lower mortality | 0.61 |
Mortality, slow LC (>96 h)
- Slow LC (>96 h) associated with increased mortality
Mortality by vasoactive combination (CART)
- Lowest-mortality combination had higher complete LC and a trend for higher %LC
Original publication
Effect of pulmonary artery catheter, type & combination of vasoactives for optimizing lactate clearance in acute myocardial infarction complicated by cardiogenic shock. J Crit Care. Published 11 December 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →