Acute cardiac care & resuscitation
Diastolic Perfusion Pressure Predicts Response to Inotropes and Vasopressors and Benefit From Mechanical Circulatory Support in Cardiogenic Shock
Authors' conclusion
Lower DPP was associated with more limited hemodynamic response to escalation of vasoactive drugs and potentially greater benefit from early venoarterial extracorporeal membrane oxygenation in CS.
Study context
- Population
- Patients with cardiogenic shock (CS)cohort of patients with CS (part 1)
- Participants
- 93 patients
- Comparison
- All-cause mortality based on baseline DPP; immediate venoarterial extracorporeal membrane oxygenation compared with early conservative management
Methodological details2 parts: cohort of patients with CS and post hoc analysis of the ECMO-CS trial
- 2 parts: cohort of patients with CS and post hoc analysis of the ECMO-CS trial
Primary result
As reported in the abstract
Vasoactive inotrope score
Escalated from
11.2±3.9
To
24.5±4.7
Further findings
| Outcome | Hazard ratio (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality, ECMO-CS trial, subgroup DPP <37 mm HgImmediate venoarterial extracorporeal membrane oxygenationvs early conservative managementPatients with DPP <37 mm Hg; lower mortality · post hoc analysis | 0.37 (0.14–0.97) | P = 0.044 | |
| 0.10.31310Hazard ratio (log scale) |
Cardiac power output index (CPOI) after escalation of vasoactive drugs
- Increases in CPOI to
- 0.23±0.06 W/m 2
- P
- P < 0.001
- All P <0.001
Postescalation CPOI
- Directly related to baseline cardiac index and DPP
Discrimination of cardiac power output responders by baseline DPP
- Optimal cutoff
- 37 mm Hg
CPOI increase and lactate clearance
- Greater in patients with baseline DPP ≥37 mm Hg
All-cause mortality, ECMO-CS trial, subgroup DPP <37 mm Hg
- No significant difference in the subgroup with DPP ≥37 mm Hg
Original publication
Diastolic Perfusion Pressure Predicts Response to Inotropes and Vasopressors and Benefit From Mechanical Circulatory Support in Cardiogenic Shock. Circ Heart Fail. Published 14 May 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →