Document Detail

Early invasive revascularisation for patients critically ill after acute myocardial infarction: impact on outcome and ICU resource utilisation.
MedLine Citation:
PMID:  16563115     Owner:  NLM     Status:  PubMed-not-MEDLINE    
OBJECTIVE: To assess the value of early invasive revascularization for the initial management of critically ill patients after acute myocardial infarction in the daily practice of a University-affiliated referral hospital and to gauge the impact of such a strategy on the intensive care unit. PATIENTS AND METHODS: A prospective observational study on all patients admitted to the Royal North Shore hospital who had acute pulmonary oedema and/or shock prior to acute angiography for acute myocardial infarction from January 1(st), 1998 to December 31, 2001. RESULTS: During the study period 846 patients with acute myocardial infarction had coronary artery angiography, 139 had acute pulmonary oedema and/or shock prior to angiography. The average age was 70 years, 65% of whom were male. Approximately 70% of these patients were admitted to the intensive care unit and coronary artery bypass surgery was performed on 38%. Of those patients admitted to the intensive care unit, 95% required mechanical ventilation, 81% required inotropic support and 50% required intra-aortic Balloon counterpulsation. In-hospital mortality was 32%, 6 weeks mortality was 38% and 6 month mortality was 42%. CONCLUSIONS: Our results confirm the benefit of early invasive revascularisation for critically ill patients after acute myocardial infarction although a substantial amount of intensive care unit resources and cardiothoracic surgical expertise were required.
A P Delaney; R P Lee; S Kay; P Hansen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine     Volume:  5     ISSN:  1441-2772     ISO Abbreviation:  Crit Care Resusc     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2006-03-27     Completed Date:  2006-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888170     Medline TA:  Crit Care Resusc     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  258-65     Citation Subset:  -    
Intensive Care Unit, Royal North Shore Hospital, Sydney, New South Wales.
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Comment In:
Crit Care Resusc. 2003 Dec;5(4):250-2   [PMID:  16563113 ]

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