Archive for the ‘Acute Myocardial Infarction’ Category

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Discussion (3)

In patients with severe CHF (pulmonary edema) while the mortality was 1.31 times higher in patients receiving PAC, this difference did not reach statistical significance. Moreover, the possibility that even in patients with pulmonary edema, those receiving PAC were “sicker,” or less responsive to treatment, cannot be excluded. We had no data on ejection fraction, […]

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Discussion (2)

The present study also showed an increased hospital mortality in patients receiving PAC, with an odds ratio on multivariate analysis of 2.98. In the patients classed as being in “pump failure,” the increased mortality was confined to those with CHF and was not present in patients with cardiogenic shock or persistent hypotension. Clinical experience suggested […]

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Discussion (1)

Despite the extensive use of PAC in patients with AMI, controversy continues to exist as to whether or not such use contributes to improvement in mortality, or possibly even increases mortality. No randomized trials have been performed, nor would the development of such trials in the future be feasible. An attempt to resolve the controversy […]

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Results (3)

The secondary analysis to assess the effect of differences in severity of CHF in patients receiving PAC compared with others revealed that of the patients who were in CHF and received PAC, 15.2 percent were mild, 28.0 percent moderate and 56.8 percent severe, whereas in the patients with CHF who did not receive PAC, 59.5 […]

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Results (2)

The higher in-hospital mortality of patients receiving PAC was present in every category of rhythm disturbance (Table 3). Table 4 shows that in patients with CHF, mortality was almost twice as high in those receiving PAC (59.4 vs 33.5 percent), while no significant difference was noted in patients with cardiogenic shock or persistent hypotension. However, […]

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Results (1)

A total of 371 patients (6.4 percent) received a PAC. The catheter was more frequently used in older age groups (Table 1) with no difference in males and females. Patients developing atrial fibrillation, high-grade atrioventricular block, ventricular tachycardia or ventricular fibrillation received the catheter a little more than twice as often as those without these […]

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Materials and Methods (2)

Hospital discharge summaries were studied of those patients receiving PAC who were not in “pump failure” to assess indications for PAC and causes of death in those who died in the hospital. In order to assess severity of CHF in the absence of cardiogenic shock and persistent hypotension, hospital discharge summaries were studied of the […]

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction: Materials and Methods (1)

Clinical Data A total of 5,841 patients with AMI hospitalized in 14 coronary care units in Israel are included in the SPRINT Registry. Of these, 2,276 patients were randomized to receive nifedipine or placebo from 7 to 21 days after die onset of the AMI, and comprise the subjects in the SPRINT Registry. Detailed information […]

Use of Pulmonary Artery Catheters in Patients with Acute Myocardial Infarction

The use of flow-directed PAC in patients admitted to the hospital with AMI was introduced in 1970. The wide acceptance of this technique for assistance in diagnosis and management of patients with AMI subsequently was questioned by some observers. In a review of ten years of experience with PAC for monitoring purposes, Swan and Ganz […]

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