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

• Verfasst von: Rusnak, Jonas [VerfasserIn]
• Verfasst von: Schupp, Tobias [VerfasserIn]
• Verfasst von: Weidner, Kathrin [VerfasserIn]
• Verfasst von: Ruka, Marinela [VerfasserIn]
• Verfasst von: Egner-Walter, Sascha [VerfasserIn]
• Verfasst von: Schmitt, Alexander [VerfasserIn]
• Verfasst von: Akin, Muharrem [VerfasserIn]
• Verfasst von: Tajti, Péter [VerfasserIn]
• Verfasst von: Mashayekhi, Kambis [VerfasserIn]
• Verfasst von: Ayoub, Mohamed [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Titel: Prognostic influence of lung compliance in patients with cardiogenic shock and invasive mechanical ventilation
• Verf.angabe: 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
• E-Jahr: 2024
• Jahr: November 2024
• Umfang: 13 S.
• Illustrationen: Illustrationen
• Fussnoten: Online veröffentlicht: 22. November 2024 ; Gesehen am 14.04.2025
• Titel Quelle: Enthalten in: Reviews in cardiovascular medicine
• Ort Quelle: New York, NY : MedReview LLC, 2000
• Jahr Quelle: 2024
• Band/Heft Quelle: 25(2024), 11, Artikel-ID 420, Seite 1-13
• ISSN Quelle: 2153-8174
• DOI: doi:10.31083/j.rcm2511420
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1922853933

Abstract

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.