Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study

Table 1 Baseline characteristics of patients in PiCCO and control groups

	PiCCO group, n = 30	Control group, n = 30	P value
Age in yr	76.37 ± 6.67	75.93 ± 6.55	0.801
Male	18 (60.0%)	16 (53.3%)	0.602
BMI	24.89 ± 2.90	24.50 ± 3.52	0.752
Comorbidities
Hypertension	18 (60.0%)	15 (50.0%)	0.436
Hyperlipidemia	8 (26.7%)	7 (23.3%)	0.766
Diabetes	8 (26.7%)	7 (23.3%)	0.766
Pneumonia	8 (26.7%)	6 (20.0%)	0.542
Respiratory failure	3 (10.0%)	4 (13.3%)	0.688
APACHE II score	24.07 ± 6.54	26.03 ± 7.00	0.266
SOFA score	10.07 ± 3.34	10.09 ± 3.23	0.330
Hs-TnI in ng/mL	0.39 ± 0.32	0.48 ± 0.32	0.304
NT-proBNP in pg/mL	10459.47 ± 4784.84	12871.13 ± 8681.39	0.189
PaO2/FiO2 in mmHg	239.18 ± 96.67	252.50 ± 109.64	0.619
Lac in mmol/L	2.32 ± 1.13	2.40 ± 1.35	0.820

Continuous data are expressed as mean ± SD. Categorical variables are expressed as n (%). PiCCO: Pulse index continuous cardiac output; BMI: Body mass index; APACHE II: Acute physiology and chronic health evaluation II; SOFA: Sequential organ failure assessment; Hs-TnI: High-sensitive Troponin I; NT-proBNP: N-terminal pro-brain natriuretic peptide; PaO2/FiO2: Oxygenation index; Lac: Lactate.

Table 2 Comparison of APACHE II score, SOFA score, Hs-TnI, NT-proBNP, PaO₂/FiO₂ and Lac on day 1, 3 and 7 after treatment between PiCCO and control groups

Group	No.	Treatment time	APACHE II score	SOFA score	Hs-TnI (ng/mL)	NT-proBNP (pg/ml)	PaO2/FiO2 (mmHg)	Lac (mmol/L)
Control group	30	1 d	25.03 ± 7.35	11.31 ± 3.57	0.54 ± 0.33	13781.31 ± 9508.70	260.32 ± 111.50	2.41 ± 1.17
		3 d	22.00 ± 5.61	9.00 ± 3.39	0.40 ± 0.35	11537.69 ± 9701.62	294.94 ± 102.80	2.30 ± 1.03
		7 d	17.57 ± 4.89	7.09 ± 3.34	0.33 ± 0.28	9083.04 ± 7702.01	341.10 ± 98.05	1.99 ± 0.70
PiCCO Group	30	1 d	21.10 ± 5.95a	8.37 ± 3.44b	0.34 ± 0.25a	8947.00 ± 5739.86a	284.05 ± 127.06	2.15 ± 1.13
		3 d	17.52 ± 4.88b	6.38 ± 3.05b	0.17 ± 0.24b	7294.83 ± 3638.23a	346.96 ± 108.39	1.80 ± 0.95
		7 d	11.89 ± 3.38b	4.07 ± 2.02b	0.11 ± 0.14b	5939.14 ± 2396.84a	395.36 ± 88.20a	1.52 ± 0.74a

Data are present as mean ± SD. Compared with control group,

^aP < 0.05 and

^bP < 0.01. PiCCO: Pulse index continuous cardiac output; APACHE II: Acute physiology and chronic health evaluation II; SOFA: Sequential organ failure assessment; Hs-TnI: High-sensitivity cardiac troponin I; NT-proBNP: N-terminal pro-brain natriuretic peptide; PaO2/FiO2: Oxygenation index; Lac: Lactate.

Table 3 Infusion and urine volume in patients in PiCCO and control groups

Group	No.	Time frame	Infusion volume in mL	Urine volume in mL
Control group	30	0-1 d	2673.52 ± 945.22	1895.28 ± 717.58
		1-2 d	2806.61 ± 724.07	2111.75 ± 684.02
		2-3 d	2643.42 ± 674.59	2199.85 ± 666.83
PiCCO group	30	0-24 h	3201.07 ± 967.64a	2492.67 ± 868.05b
		24-48 h	3162.48 ± 770.95	2363.10 ± 755.36
		48-72 h	2842.76 ± 765.30	2502.76 ± 728.34

Data are present as mean ± SD.

^aP < 0.05,

^bP < 0.01, vs control group. PiCCO: Pulse index continuous cardiac output.

Table 4 Comparison of primary and secondary outcomes between PiCCO and control groups

	PiCCO group, n = 30	Control group, n = 30	P value
Primary outcome
ADL score	66.83 ± 14.65	11.33 ± 5.71	0.000
Secondary outcomes
Days on vasoactive agents	10.04 ± 2.52	12.09 ± 3.16	0.013
Duration of mechanical ventilation in d	8.13 ± 1.51	10.81 ± 2.10	0.000
Days on MV	9.21 ± 4.40	12.39 ± 4.14	0.011
EICU/CCU length of stay	12.57 ± 2.78	14.83 ± 2.59	0.005
Pulmonary edema	18 (60%)	21 (70%)	0.589

Continuous data are expressed as mean ± SD. Categorical variables are expressed as n (%). PiCCO: Pulse index continuous cardiac output; ADL: Activities of daily living scale; MV: Mechanical ventilation; EICU: Emergency intensive care unit; CCU: Coronary care unit.

Table 5 The monitoring indexes of PiCCO group at three point-in-times

Index	24 h	48 h	72 h	Integral analysis			Multiple comparison
				Adjustment coefficients	F	P	P1	P2	P3
CI in L/min/m2	2.16 ± 0.43	2.62 ± 0.39	2.88 ± 0.91	0.835	13.723	0.001	0.000	0.000	0.104
EVLWI in mL/kg	8.95 ± 1.85	7.59 ± 1.45	6.84 ± 0.82	1.024	21.669	0.000	0.001	0.000	0.018
ITBVI in mL/m2	972.49 ± 104.28	753.91 ± 85.28	583.18 ± 65.61	0.799	199.825	0.000	0.000	0.000	0.000
GEDVI in mL/m2	783.85 ± 88.36	604.28 ± 94.11	452.29 ± 67.89	0.948	133.476	0.000	0.000	0.000	0.000

P₁ is 48 h vs 24 h, P₂ is 72 h vs 24 h, and P₃ is 72 h vs 48 h. CI: Cardiac index; EVLWI: Extravascular lung water index; ITBVI: Intrathoracic blood volume Index; GEDVI: Global end diastolic volume index.