| Title: |
Mottling as a prognosis marker in cardiogenic shock |
| Authors: |
Merdji, H. (Hamid); Bataille, V. (Vincent); Curtiaud, A. (Anais); Bonello, L. (Laurent); Roubille, F. (François); Levy, B. (Bruno); Lim, P. (Pascal); Schneider, F. (Francis); Khachab, H. (Hadi); Dib, J. (Jean-Claude); Seronde, M. (Marie-France); Schurtz, G. (Guillaume); Harbaoui, B. (Brahim); Vanzetto, G. (Gerald); Marchand, S. (Severine); Gebhard, C. (Caroline Eva); Henry, P. (Patrick); Combaret, N. (Nicolas); Marchandot, B. (Benjamin); Lattuca, B. (Benoit); Biendel, C. (Caroline); Leurent, G. (Guillaume); Gerbaud, E. (Edouard); Puymirat, E. (Etienne); Bonnefoy, E. (Eric); Meziani, F. (Ferhat); Delmas, C. (Clément) |
| Publication Year: |
2023 |
| Subject Terms: |
Aucun |
| Description: |
Aims: Impact of skin mottling has been poorly studied in patients admitted for cardiogenic shock. This study aimed to address this issue and identify determinants of 30-day and 1-year mortality in a large cardiogenic shock cohort of all etiologies. Methods and results: FRENSHOCK is a prospective multicenter observational registry conducted in French critical care units between April and October, 2016. Among the 772 enrolled patients (mean age 65.7 ± 14.9 years; 71.5% male), 660 had skin mottling assessed at admission (85.5%) with almost 39% of patients in cardiogenic shock presenting mottling. The need for invasive respiratory support was significantly higher in patients with mottling (50.2% vs. 30.1%, p < 0.001) and likewise for the need for renal replacement therapy (19.9% vs. 12.4%, p = 0.09). However, the need for mechanical circulatory support was similar in both groups. Patients with mottling at admission presented a higher length of stay (19 vs. 16 days, p = 0.033), a higher 30-day mortality rate (31% vs. 23.3%, p = 0.031), and also showed significantly higher mortality at 1-year (54% vs. 42%, p = 0.003). The subgroup of patients in whom mottling appeared during the first 24 h after admission had the worst prognosis at 30 days. Conclusion: Skin mottling at admission in patients with cardiogenic shock was statistically associated with prolonged length of stay and poor outcomes. As a perfusion-targeted resuscitation parameter, mottling is a simple, clinical-based approach and may thus help to improve and guide immediate goal-directed therapy to improve cardiogenic shock patients' outcomes. Keywords: Acute heart failure; Cardiogenic shock; Microcirculation; Perfusion. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1186/s13613-023-01175-0 |
| Availability: |
https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01175-0 |
| Rights: |
Paternité [CC] [BY] ; info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.5F13E3EA |
| Database: |
BASE |