Effect of Early Protective Lung Ventilation on Mortality and Hemodynamics in Patients With Acute Myocardial Infarction Complicated With Cardiogenic Shock and Pulmonary Edema Undergoing Emergency Interventional Therapy
Abstract Background: To investigate the effect of early protective lung ventilation (EPLV) on mortality and hemodynamic parameters in patients with acute myocardial infarction complicated with cardiogenic shock (CS) and pulmonary edema undergoing emergency percutaneous coronary intervention (PCI).Methods: From January 2015 to June 2017, patients with acute myocardial infarction complicated with CS and pulmonary edema were admitted to the Tianjin chest Hospital. Based on the use of a mechanical ventilator, patients were divided into the EPLV and Non-invasive ventilation (NIV) groups. Hemodynamic indexes and in-hospital mortality of patients between the two groups was analyzed.Results: The EPLV group consisted of 51 patients and the NIV group consisted of 38 patients. The difference in mortality rates was statistically significant between the EPLV and NIV groups (P=0.01). Central venous pressure, pulmonary artery pressure, and pulmonary capillary wedge pressure after emergency PCI in the EPLV group were lower compared to patients in the NIV group ((P<0.05). Man arterial pressure in patients in the EPLV group was higher compared to NIV patients (P<0.05). Logistic regression analysis showed that EPLV did not increase the risk of mortality (P=0.37, OR=2.16, 95% CI (0.31, 9.52)).Conclusion: EPLV resulted in lower mortality and improved hemodynamic function in patients with acute myocardial infarction complicated with CS and pulmonary edema undergoing emergency PCI.
