Treatment strategies for acute myocardial infarction complicated by cardiogenic shock in a community hospital.

Abstract:

:The risk and benefits of three treatment strategies were examined in 64 consecutive patients with acute myocardial infarction and cardiogenic shock. Thirteen patients received thrombolytic therapy (group 1), 29 patients received intra-aortic balloon pump counterpulsation support (group 2), and 22 patients were treated with combined thrombolytic therapy and intra-aortic balloon pump counterpulsation support (group 3). The groups were similar in regard to age, sex, medical history, hemodynamic data, and extent of coronary artery disease. Survival was improved in patients treated with combined thrombolytic therapy and intra-aortic balloon pump counterpulsation support (group 1, 23 percent; group 2, 28 percent; and group 3, 68 percent; p = 0.0049). Seven percent of the patients who remained at the community hospital survived vs 69 percent who were transferred to a tertiary care center (p < 0.001), and 17 percent survived who were treated medically vs 71 percent who received revascularization (p < 0.001). These findings suggest that patients who present to a community hospital in cardiogenic shock can have their conditions stabilized, and they can then be transferred to a tertiary care hospital for revascularization and have the same outcome as patients who initially present to tertiary care hospitals.

journal_name

Chest

journal_title

Chest

authors

Stomel RJ,Rasak M,Bates ER

doi

10.1378/chest.105.4.997

subject

Has Abstract

pub_date

1994-04-01 00:00:00

pages

997-1002

issue

4

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(16)57650-8

journal_volume

105

pub_type

杂志文章

相关文献

CHEST文献大全
  • The effectiveness of cardiology consultation. Concordance with diagnostic and drug recommendations.

    abstract::In an effort to characterize the effectiveness of cardiology consultation, the outcomes of consultants' recommendations for diagnostic actions and cardiac drugs were quantitatively examined in 394 cases. Drug recommendations were made more frequently (49 percent) than diagnostic recommendations (38 percent) and were a...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.79.1.16

    authors: Mackenzie TB,Popkin MK,Callies AL,Jorgensen CR,Cohn JN

    更新日期:1981-01-01 00:00:00

  • Pleural calcification associated with exposure to chrysotile asbestos in southeast Turkey.

    abstract::In this study, pleural calcifications prevailing in the inhabitants of some villages and towns around Diyarbakir, a city in southeast Turkey, have been found to be caused by the inhalation of chrysotile asbestos, the mineral commonly used indiscriminately to paint the walls and floors of houses. There were no industri...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.70.1.43

    authors: Yazicioglu S

    更新日期:1976-07-01 00:00:00

  • Atypical presentations and echocardiographic findings in patients with cardiac tamponade occurring early and late after cardiac surgery.

    abstract::Cardiac tamponade, a potentially lethal complication following cardiac surgery, may present either early or late postoperatively and may be difficult to diagnose due to atypical clinical, hemodynamic, or echocardiographic findings. To determine the frequency and clinical features of postoperative cardiac tamponade, we...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.1.71

    authors: Russo AM,O'Connor WH,Waxman HL

    更新日期:1993-07-01 00:00:00

  • Tracheoesophageal and aortoesophageal fistulae complicating corrosive esophagitis.

    abstract::A 51-year-old man suffered third-degree caustic burns of the esophagus and proximal two-thirds of the stomach. A tracheoesophageal fistula developed, and surgery was performed to exclude the esophagus from gastrointestinal reflux and to divert the oral secretions. An uneventful postoperative course was interrupted on ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.70.4.549

    authors: Singh AK,Kothawla LK,Karlson KE

    更新日期:1976-10-01 00:00:00

  • Dilated right ventricular cardiomyopathy: Uhl's disease.

    abstract::Uhl's disease is a rare disorder originally described in 1952 in an infant with severe diffuse right ventricular dysfunction with total absence of the myocardium. Uhl considered the disease to be congenital in origin. We report a patient with severe dilated congestive cardiomyopathy limited to the right ventricle but ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.90.2.300

    authors: Bewick DJ,Chandler BM,Montague TJ

    更新日期:1986-08-01 00:00:00

  • Venous thromboembolism, thrombophilia, antithrombotic therapy, and pregnancy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition).

    abstract::This article discusses the management of venous thromboembolism (VTE) and thrombophilia, as well as the use of antithrombotic agents, during pregnancy and is part of the American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Grade 1 recommendations are strong and indicate that ...

    journal_title:Chest

    pub_type: 杂志文章,实务指引

    doi:10.1378/chest.08-0761

    authors: Bates SM,Greer IA,Pabinger I,Sofaer S,Hirsh J

    更新日期:2008-06-01 00:00:00

  • Postnasal drip causes cough and is associated with reversible upper airway obstruction.

    abstract::We prospectively evaluated nine patients with cough from postnasal drip for evidence of extrathoracic upper airway obstruction. Patients compared before treatment to normal control subjects had physiologic evidence of extrathoracic upper airway obstruction; their mean FIF50%/FEF50% and FIF25-75%/FEF25-75% ratios of 0....

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.85.3.346

    authors: Irwin RS,Pratter MR,Holland PS,Corwin RW,Hughes JP

    更新日期:1984-03-01 00:00:00

  • Methodology for guideline development for the Seventh American College of Chest Physicians Conference on Antithrombotic and Thrombolytic Therapy: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy.

    abstract::This article describes the methodology for the Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy: Evidence-Based Guidelines. Guideline authors began by specifying the population, the intervention and alternative, and the outcomes for each clinical question, and d...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.126.3_suppl.174S

    authors: Schünemann HJ,Munger H,Brower S,O'Donnell M,Crowther M,Cook D,Guyatt G

    更新日期:2004-09-01 00:00:00

  • New serum indicator of interstitial pneumonitis activity. Sialylated carbohydrate antigen KL-6.

    abstract::Serum levels of a high molecular weight circulating antigen KL-6, detected by means of a sandwich assay using a monoclonal antibody KL-6 against a sialylated carbohydrate antigen, were evaluated for usefulness in monitoring the activity of interstitial pneumonitis. Abnormally high levels of KL-6 antigen were observed ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.96.1.68

    authors: Kohno N,Kyoizumi S,Awaya Y,Fukuhara H,Yamakido M,Akiyama M

    更新日期:1989-07-01 00:00:00

  • Bronchoalveolar pepsin, bile acids, oxidation, and inflammation in children with gastroesophageal reflux disease.

    abstract:INTRODUCTION:Gastroesophageal reflux has been suggested as an underlying cause of chronic lung disease. The aim of this study was to assess the value of pepsin and bile acids, both components of GI secretions, in the lungs of children with chronic lung diseases as possible markers for gastroesophageal reflux disease an...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-0316

    authors: Starosta V,Kitz R,Hartl D,Marcos V,Reinhardt D,Griese M

    更新日期:2007-11-01 00:00:00

  • Oral treprostinil for the treatment of pulmonary arterial hypertension in patients on background endothelin receptor antagonist and/or phosphodiesterase type 5 inhibitor therapy (the FREEDOM-C study): a randomized controlled trial.

    abstract:BACKGROUND:Infused and inhaled treprostinil are effective for treatment of pulmonary arterial hypertension (PAH), although their administration routes have limitations. This study assessed the efficacy and safety of bid oral sustained-release treprostinil in the treatment of PAH with a concomitant endothelin receptor a...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.11-2212

    authors: Tapson VF,Torres F,Kermeen F,Keogh AM,Allen RP,Frantz RP,Badesch DB,Frost AE,Shapiro SM,Laliberte K,Sigman J,Arneson C,Galiè N

    更新日期:2012-12-01 00:00:00

  • Pulmonary dead space fraction and pulmonary artery systolic pressure as early predictors of clinical outcome in acute lung injury.

    abstract:STUDY OBJECTIVE:The primary objective of this study was to test whether an elevated systolic pulmonary artery (PA) pressure or an elevated pulmonary dead space fraction (Vd/Vt) in early acute lung injury (ALI) is associated with poor clinical outcomes in the era of lung-protective ventilation. DESIGN:Prospective obser...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.07-0409

    authors: Cepkova M,Kapur V,Ren X,Quinn T,Zhuo H,Foster E,Liu KD,Matthay MA

    更新日期:2007-09-01 00:00:00

  • Figure-eight kinking of the aorta (pseudocoarctation) coexistent with coarctation.

    abstract::An asymptomatic young man presented with a cardiac murmur and hypertension only in the right arm. Angiograms showed kinking of the aortic arch with a figure-eight appearance consistent with pseudocoarctation. Before the kinked segment, also demonstrated were a stenotic lesion in the aortic arch proximal to the left ca...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.5.1239

    authors: Tsai LM,Fu M,Chang CH,Hung JS

    更新日期:1990-05-01 00:00:00

  • Pulmonary section development influences general medical house officer interests and ABIM certifying examination performance.

    abstract::To determine whether sectional development in pulmonary and critical care medicine influences medical house officers' (HO) interests and knowledge about respiratory medicine, we reviewed HO performance on the American Board of Internal Medicine (ABIM) certifying examination during 4 years before and 5 years after reor...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.110.2.533

    authors: Haponik EF,Bowton DL,Chin R Jr,Adair NE,Lykens MG,Alford PT,Bass DA

    更新日期:1996-08-01 00:00:00

  • A longitudinal study of lung function in nonsmoking patients with rheumatoid arthritis.

    abstract:STUDY OBJECTIVE:s: Patients with rheumatoid arthritis (RA) have a high prevalence of pulmonary function test (PFT) abnormality, but the long-term significance of this is unknown. We performed a longitudinal study of pulmonary function in asymptomatic, nonsmoking patients with active RA requiring disease-modifying drugs...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.124.4.1224

    authors: Fuld JP,Johnson MK,Cotton MM,Carter R,Watkin SW,Capell HA,Stevenson RD

    更新日期:2003-10-01 00:00:00

  • Coronary atherosclerosis in mitral stenosis.

    abstract::Eighty-two patients with mitral stenosis underwent cardiac catheterization with coronary angiography. Twenty-one patients (26 percent) had coronary artery disease. Characteristics of the mitral valve area, cardiac output, pulmonary artery pressure, pulmonary vascular resistance, left ventricular end-diastolic pressure...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.81.1.36

    authors: Chun PK,Gertz E,Davia JE,Cheitlin MD

    更新日期:1982-01-01 00:00:00

  • Comparing cost of indwelling pleural catheter vs talc pleurodesis for malignant pleural effusion.

    abstract:BACKGROUND:Malignant pleural effusion is associated with short life expectancy and significant morbidity. A randomized controlled trial comparing indwelling pleural catheters (IPCs) with talc pleurodesis found that IPCs reduced in-hospital time and the need for additional procedures but were associated with excess adve...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1378/chest.13-2481

    authors: Penz ED,Mishra EK,Davies HE,Manns BJ,Miller RF,Rahman NM

    更新日期:2014-10-01 00:00:00

  • The effect of oxygen with exercise on atrial natriuretic peptide in chronic obstructive lung disease.

    abstract::A recent study on stable, hypoxemic, COLD patients in which ANP was stimulated by LBPP demonstrated that in these individuals elevation of ANP does not exert a "normal" suppressing effect on the PRA-PA axis. Accordingly, we exercised ten comparable COLD patients, another maneuver known to stimulate ANP and to elicit c...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.101.2.341

    authors: Mannix ET,Manfredi F,Palange P,Aronoff GR,Weinberger MH,Farber MO

    更新日期:1992-02-01 00:00:00

  • Spontaneous echo contrast in massive pericardial effusion with tamponade.

    abstract::Spontaneous echo contrast is uncommon in pericardial effusion. We report the case of a patient with massive malignant pericardial effusion causing cardiac tamponade in which the intense spontaneous echo contrast was found in the effusion by echocardiography. It was suggested that both the heavy blood content and a lar...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.103.5.1600

    authors: Shyu KG,Cheng JJ,Kuan P,Lien WP

    更新日期:1993-05-01 00:00:00

  • Effect of naloxone on maximal exercise performance and control of ventilation in COPD.

    abstract::Elevated endorphin levels in patients with COPD may act to diminish the sensation of dyspnea. Exogenous opioids decrease exertional dyspnea and increase exercise capacity in COPD patients. The purpose of this study was to determine the effects of endogenous opioids on the exercise capacity and control of breathing in ...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.96.4.761

    authors: Kirsch JL,Muro JR,Stansbury DW,Fischer CE,Monfore R,Light RW

    更新日期:1989-10-01 00:00:00

  • Effect of filtration and concentration on the composition of bronchoalveolar lavage fluid.

    abstract::The effects of filtration and concentration on the cellular and protein composition of bronchoalveolar lavage fluids were examined in ten normal subjects and 11 patients with asthma. Filtration of lavage fluid preferentially removed bronchial epithelial cells, resulting in a relative increase in the proportion of alve...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.87.6.740

    authors: Lam S,LeRiche JC,Kijek K

    更新日期:1985-06-01 00:00:00

  • Treatment of the adult respiratory distress syndrome with continuous positive airway pressure.

    abstract::Fifteen patients in the early stages of the adult respiratory distress syndrome with severe hypoxemia who were capable of maintaining adequate spontaneous ventilation were treated with continuous positive airway pressure (CPAP). The optimal level of CPAP was adjusted for each patient to achieve the highest oxygenation...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.76.3.257

    authors: Venus B,Jacobs HK,Lim L

    更新日期:1979-09-01 00:00:00

  • Mucoid impaction of upper lobe bronchi in the absence of proximal bronchiectasis.

    abstract::Mucoid impaction is a complication of asthma and is frequently recurrent in patients with allergic bronchopulmonary aspergillosis (ABPA). This report describes a patient with asthma and recurrent bilateral well-circumscribed densities on chest roentgenogram in the absence of ABPA. Recognition of this clinical presenta...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.4.1023

    authors: Anderson WM

    更新日期:1990-10-01 00:00:00

  • New procedure: bronchoscopic endobronchial sealing; a new mode of managing hemoptysis.

    abstract::Six patients with hemoptysis were treated by endobronchial sealing, with n-butyl cyanoacrylate, of the bleeding segment or subsegment. There was an immediate arrest of bleeding without any recurrence for a mean follow-up period of 127 (+/- 67.17) days. Endobronchial sealing appears to be an effective method of managin...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.121.6.2066

    authors: Bhattacharyya P,Dutta A,Samanta AN,Chowdhury SR

    更新日期:2002-06-01 00:00:00

  • Regulation of breathing and perception of dyspnea in healthy pregnant women.

    abstract:STUDY OBJECTIVE:To examine if the perception of dyspnea during normal pregnancy may be related to an inappropriate ventilatory response to the increased metabolic rate, due to a higher chemosensitivity. PATIENTS AND INTERVENTIONS:At weeks 12, 24, and 36 of gestation and 4 months after delivery, 11 healthy pregnant wom...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.110.2.446

    authors: García-Rio F,Pino JM,Gómez L,Alvarez-Sala R,Villasante C,Villamor J

    更新日期:1996-08-01 00:00:00

  • Effects of inhaled anticholinergic drug on dyspnea and gas exchange during exercise in patients with chronic obstructive pulmonary disease.

    abstract::To elucidate the effect of oxitropium bromide (OTB), an anticholinergic drug, on dyspnea and gas exchange during exercise in patients with chronic obstructive pulmonary disease (COPD), we performed the cycle exercise test on 19 patients with COPD (mean age, 72.0 +/- 1.9 years; mean FEV1, 1.28 +/- 0.07 L) before and af...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.103.6.1774

    authors: Teramoto S,Fukuchi Y,Orimo H

    更新日期:1993-06-01 00:00:00

  • Eliminating asthma disparities: introduction to the Chicago story.

    abstract::The problem of inner-city asthma, as studied in Chicago, IL, is introduced. Chicago has a high incidence of asthma, but prevalence, morbidity, and mortality rates vary by neighborhood and are highest in neighborhoods with the lowest socioeconomic status. Efforts in Chicago to mitigate these gaps have been extraordinar...

    journal_title:Chest

    pub_type:

    doi:10.1378/chest.07-1929

    authors: Weiss KB

    更新日期:2007-11-01 00:00:00

  • Preventing ARDS: progress, promise, and pitfalls.

    abstract::Advances in critical care practice have led to a substantial decline in the incidence of ARDS over the past several years. Low tidal volume ventilation, timely resuscitation and antimicrobial administration, restrictive transfusion practices, and primary prevention of aspiration and nosocomial pneumonia have likely co...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.14-0555

    authors: Beitler JR,Schoenfeld DA,Thompson BT

    更新日期:2014-10-01 00:00:00

  • Inhalation challenge with bovine dander allergens: who needs it?

    abstract:STUDY OBJECTIVES:To identify which tests would be useful in selecting patients for a specific inhalation challenge with bovine dander allergens (bSIC). DESIGN:A prospective study. SETTING:A university hospital. PATIENTS:Thirty-seven dairy farmers with a clinical suspicion of occupational asthma due to bovine allerge...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.124.1.383

    authors: Koskela H,Taivainen A,Tukiainen H,Chan HK

    更新日期:2003-07-01 00:00:00

  • Löffler's syndrome secondary to crack cocaine.

    abstract::Eosinophilic pulmonary infiltration is an uncommon presentation from cocaine abuse. We present a patient with migratory pulmonary infiltrates and eosinophilia consistent with Löffler's syndrome. Our review uncovered two other similar patients. The importance of early recognition is stressed in our report. Either absti...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.105.5.1599

    authors: Nadeem S,Nasir N,Israel RH

    更新日期:1994-05-01 00:00:00