Document Detail


Microbiological profile of septic complication in patients with cardiogenic shock following acute myocardial infarction (from the SHOCK study).
MedLine Citation:
PMID:  17350369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We sought to assess the microbiologic profile of patients with suspected sepsis who participated in the SHould we emergently revascularize Occluded Coronaries in cardiogenic shocK? (SHOCK) trial, a randomized controlled trial of early coronary revascularization in patients with cardiogenic shock complicating acute myocardial infarction. A protocol-mandated SEPSIS form was completed prospectively for 54 patients (18%) with fever or leukocytosis suggestive of sepsis. These patients were divided further into those with positive (n = 40) or negative (n = 14) culture results. The predominant pathogen isolated in patients with positive culture results was Staphylococcus aureus (32%), followed by Klebsiella pneumoniae and Pseudomonas aeruginosa. Patients with both positive and negative culture results had longer median durations of mechanical ventilation (p <0.001 and p = 0.02), intra-aortic balloon pump (IABP) support (p = 0.074 and p = 0.021), and hospital stay (p <0.001 and p = 0.048) than controls. Sepsis was predicted by both duration of IABP support (p = 0.007) and use of multiple central catheters (p = 0.026). In conclusion, clinical sepsis is common after cardiogenic shock complicating acute myocardial infarction, particularly in patients who received prolonged IABP support or had multiple central catheters.
Authors:
Shun Kohsaka; Venu Menon; Kentaro Iwata; April Lowe; Lynn A Sleeper; Judith S Hochman;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-01-16
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-12     Completed Date:  2007-04-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  802-4     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Columbia University, College of Physicians and Surgeons, New York, New York, USA. sk2798@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Bacteremia / blood,  epidemiology*,  etiology,  microbiology
Catheterization / adverse effects
Female
Gram-Negative Bacteria / isolation & purification*
Humans
Intensive Care Units
Intra-Aortic Balloon Pumping / adverse effects
Klebsiella pneumoniae / isolation & purification
Length of Stay
Male
Middle Aged
Pseudomonas aeruginosa / isolation & purification
Randomized Controlled Trials as Topic
Respiration, Artificial / adverse effects
Shock, Cardiogenic / complications*
Staphylococcus aureus / isolation & purification*

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