Merdji Hamid, Bataille Vincent, Curtiaud Anais, Bonello Laurent, Roubille François, Levy Bruno, Lim Pascal, Dib Jean-Claude, Maizel Julien, Brechot Nicolas, Beuzelin Marion, Fillippi Emmanuelle, Cherbi Miloud, Demiselle Julien, Rangé Grégoire, Joffre Jérémie, Yassine Marwan, Biendel Caroline, Bounes Fanny, Leurent Guillaume, Gerbaud Edouard, Bonnefoy Eric, Puymirat Etienne, Delmas Clément
Université de Strasbourg (UNISTRA), Faculté de Médecine, Strasbourg University Hospital, Nouvel Hôpital Civil, Medical Intensive Care Unit, Strasbourg, France.
Department of Cardiology, Toulouse Rangueil University Hospital, UMR 1295 INSERM, Toulouse, France.
Resusc Plus. 2025 Jul 9;25:101024. doi: 10.1016/j.resplu.2025.101024. eCollection 2025 Sep.
Differences between cardiogenic shock (CS) with and without prior resuscitated cardiac arrest (CA) remain largely unexplored. We hypothesized that patients who experience shockable CA followed by CS are likely to have worse outcomes compared to CS without prior CA.
FRENSHOCK is a prospective multicenter observational registry conducted in French critical care units in 2016, which included CS from various etiologies. Patients admitted after resuscitation of a CA were included if they fulfilled previously defined CS criteria. Non-shockable rhythms at the time of medical intervention were considered exclusion criteria and were not recorded in the registry.
Among the 771 enrolled patients (mean age 65.7 ± 14.9 years; 71.5 % male), 79 (10.2 %) had a resuscitated shockable cardiac arrest just before inclusion. Shockable CA patients had more respiratory support (78.5 % vs. 33.2 %, < 0.001), more mechanical circulatory support (35.4 % vs. 16.5 %, < 0.001), more coronary angiography performed (76 % vs. 48.8 %, < 0.001), finding more mono-troncular lesions (39 % vs. 16.9 %, < 0.001). Thirty-day and one-year survival were similar between groups. Among 30-day survivors, CS with an initial shockable CA exhibited significantly improved long-term survival compared to CS without prior resuscitated CA.
In a cohort of patients with cardiogenic shock from various etiologies, approximately 10% had experienced prior resuscitation following a cardiac arrest with shockable rhythms. Our findings suggest that selected cardiac arrest with a shockable rhythm leading to cardiogenic shock does not inherently confer a worse prognosis compared to other causes of cardiogenic shock.
心源性休克（CS）伴有或不伴有先前复苏的心脏骤停（CA）之间的差异在很大程度上仍未得到探索。我们假设，与无先前CA的CS患者相比，经历可电击复律的CA后发生CS的患者可能预后更差。
FRENSHOCK是2016年在法国重症监护病房进行的一项前瞻性多中心观察性登记研究，纳入了各种病因导致的CS患者。如果符合先前定义的CS标准，则纳入CA复苏后入院的患者。医疗干预时不可电击复律的心律被视为排除标准，未记录在登记研究中。
在771名登记患者中（平均年龄65.7±14.9岁；71.5%为男性），79名（10.2%）在纳入前有复苏成功的可电击复律心脏骤停。可电击复律CA患者有更多的呼吸支持（78.5%对33.2%，P<0.001）、更多的机械循环支持（35.4%对16.5%，P<0.001）、更多的冠状动脉造影检查（76%对48.8%，P<0.001），发现更多的单支血管病变（39%对16.9%，P<0.001）。两组间30天和1年生存率相似。在30天幸存者中，初始为可电击复律CA的CS患者与无先前复苏CA的CS患者相比，长期生存率显著提高。
在一组各种病因的心源性休克患者中，约10%曾经历过心脏骤停且心律可电击复律后的复苏。我们的研究结果表明，与其他心源性休克原因相比，特定的可电击复律心律导致的心源性休克本身并不意味着预后更差。
