Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study.
PURPOSE:Patients with acute myocardial infarction (AMI) and respiratory impairment may be treated with either invasive or non-invasive mechanical ventilation (MV). However, there has been little testing of non-invasive MV in the setting of AMI. Our objective was to evaluate the incidence and associa...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4792462?pdf=render |
| _version_ | 1818282340270473216 |
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| author | Antonio Eduardo P Pesaro Marcelo Katz Jason N Katz Carmen Sílvia Valente Barbas Marcia R Makdisse Alessandra G Correa Marcelo Franken Carolina Pereira Carlos V Serrano Renato D Lopes |
| author_facet | Antonio Eduardo P Pesaro Marcelo Katz Jason N Katz Carmen Sílvia Valente Barbas Marcia R Makdisse Alessandra G Correa Marcelo Franken Carolina Pereira Carlos V Serrano Renato D Lopes |
| author_sort | Antonio Eduardo P Pesaro |
| collection | DOAJ |
| description | PURPOSE:Patients with acute myocardial infarction (AMI) and respiratory impairment may be treated with either invasive or non-invasive mechanical ventilation (MV). However, there has been little testing of non-invasive MV in the setting of AMI. Our objective was to evaluate the incidence and associated clinical outcomes of patients with AMI who were treated with non-invasive or invasive MV. METHODS:This was a retrospective observational study in which consecutive patients with AMI (n = 1610) were enrolled. The association between exclusively non-invasive MV, invasive MV and outcomes was assessed by multivariable models. RESULTS:Mechanical ventilation was used in 293 patients (54% invasive and 46% exclusively non-invasive). In-hospital mortality rates for patients without MV, with exclusively non-invasive MV, and with invasive MV were 4.0%, 8.8%, and 39.5%, respectively (P<0.001). The median lengths of hospital stay were 6 (5.8-6.2), 13 (11.2-4.7), and 28 (18.0-37.9) days, respectively (P<0.001). Exclusively non-invasive MV was not associated with in-hospital death (adjusted HR = 0.90, 95% CI 0.40-1.99, P = 0.79). Invasive MV was strongly associated with a higher risk of in-hospital death (adjusted HR = 3.07, 95% CI 1.79-5.26, P<0.001). CONCLUSIONS:In AMI setting, 18% of the patients required MV. Almost half of these patients were treated with exclusively non-invasive strategies with a favorable prognosis, while patients who needed to be treated invasively had a three-fold increase in the risk of death. Future prospective randomized trials are needed to compare the effectiveness of invasive and non-invasive MV for the initial approach of respiratory failure in AMI patients. |
| first_indexed | 2024-12-13T00:19:27Z |
| format | Article |
| id | doaj.art-b2dec8775abe4d86a6309eaa4fc56313 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-13T00:19:27Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b2dec8775abe4d86a6309eaa4fc563132022-12-22T00:05:40ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01113e015130210.1371/journal.pone.0151302Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study.Antonio Eduardo P PesaroMarcelo KatzJason N KatzCarmen Sílvia Valente BarbasMarcia R MakdisseAlessandra G CorreaMarcelo FrankenCarolina PereiraCarlos V SerranoRenato D LopesPURPOSE:Patients with acute myocardial infarction (AMI) and respiratory impairment may be treated with either invasive or non-invasive mechanical ventilation (MV). However, there has been little testing of non-invasive MV in the setting of AMI. Our objective was to evaluate the incidence and associated clinical outcomes of patients with AMI who were treated with non-invasive or invasive MV. METHODS:This was a retrospective observational study in which consecutive patients with AMI (n = 1610) were enrolled. The association between exclusively non-invasive MV, invasive MV and outcomes was assessed by multivariable models. RESULTS:Mechanical ventilation was used in 293 patients (54% invasive and 46% exclusively non-invasive). In-hospital mortality rates for patients without MV, with exclusively non-invasive MV, and with invasive MV were 4.0%, 8.8%, and 39.5%, respectively (P<0.001). The median lengths of hospital stay were 6 (5.8-6.2), 13 (11.2-4.7), and 28 (18.0-37.9) days, respectively (P<0.001). Exclusively non-invasive MV was not associated with in-hospital death (adjusted HR = 0.90, 95% CI 0.40-1.99, P = 0.79). Invasive MV was strongly associated with a higher risk of in-hospital death (adjusted HR = 3.07, 95% CI 1.79-5.26, P<0.001). CONCLUSIONS:In AMI setting, 18% of the patients required MV. Almost half of these patients were treated with exclusively non-invasive strategies with a favorable prognosis, while patients who needed to be treated invasively had a three-fold increase in the risk of death. Future prospective randomized trials are needed to compare the effectiveness of invasive and non-invasive MV for the initial approach of respiratory failure in AMI patients.http://europepmc.org/articles/PMC4792462?pdf=render |
| spellingShingle | Antonio Eduardo P Pesaro Marcelo Katz Jason N Katz Carmen Sílvia Valente Barbas Marcia R Makdisse Alessandra G Correa Marcelo Franken Carolina Pereira Carlos V Serrano Renato D Lopes Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study. PLoS ONE |
| title | Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study. |
| title_full | Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study. |
| title_fullStr | Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study. |
| title_full_unstemmed | Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study. |
| title_short | Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study. |
| title_sort | mechanical ventilation and clinical outcomes in patients with acute myocardial infarction a retrospective observational study |
| url | http://europepmc.org/articles/PMC4792462?pdf=render |
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