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

Barbas, Carmen Sílvia Valente

Correa, Alessandra G.

Franken, Marcelo

Katz, Jason N.

Katz, Marcelo

Lopes, Renato D.

Makdisse, Marcia R.

Pereira, Carolina

Pesaro, Antonio Eduardo P.

Serrano, Carlos V.

PLoS ONE

English

PubMed

<div>PurposePatients 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.MethodsThis 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.ResultsMechanical 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).ConclusionsIn 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.</div

Antonio Eduardo P. Pesaro (3179676)

Marcelo Katz (695963)

Jason N. Katz (3179682)

Carmen Sílvia Valente Barbas (60695)

Marcia R. Makdisse (3179679)

Alessandra G. Correa (3179673)

Marcelo Franken (3179667)

Carolina Pereira (3179670)

Carlos V. Serrano Jr. (3179661)

Renato D. Lopes (3179664)

FigShare

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 associated clinical outcomes of patients with AMI who were treated with noninvasive 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 noninvasive). 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.Hosp Israelita Albert Einstein, Sao Paulo, SP, BrazilUniv N Carolina, Div Cardiol, Chapel Hill, NC USAUniv Sao Paulo, Sch Med, Dept Pulm, Heart Inst INCOR, Sao Paulo, SP, BrazilUniv Sao Paulo, Sch Med, Heart Inst INCOR, Sao Paulo, BrazilDuke Univ, Med Ctr, Duke Clin Res Inst, Durham, NC USAUniv Fed Sao Paulo, Paulista Sch Med, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Paulista Sch Med, Sao Paulo, SP, BrazilWeb of Scienc

Valente Barbas, Carmen Silvia

Serrano, Carlos V., Jr.

Lopes, Renato D. [UNIFESP]

LAReferencia - Red Federada de Repositorios Institucionales de Publicaciones Científicas Latinoamericanas

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

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

Directory of Open Access Journals

Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study.

Repositório Institucional UNIFESP

Carolina Digital Repository

Antonio Eduardo P. Pesaro

Jason N. Katz

Marcia R. Makdisse

Alessandra G. Correa

Carlos V. Serrano

Renato D. Lopes

Crossref

https://repositorio.unifesp.br/bitstream/handle/11600/57786/WOS000372572800057.pdf?sequence=1&isAllowed=y

Mechanical Ventilation and Clinical Outcomes in Patients with Acute Myocardial Infarction: A Retrospective Observational Study

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