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Heart & Lung: the Journal of Critical Care

John E Madias
No abstract text is available yet for this article.
October 7, 2016: Heart & Lung: the Journal of Critical Care
Jennifer B Seaman, Amber E Barnato, Susan M Sereika, Mary Beth Happ, Judith A Erlen
OBJECTIVE: Describe patterns of palliative care service consultation among a sample of ICU patients at high risk of dying. BACKGROUND: Patients receiving mechanical ventilation (MV) face threats to comfort, social connectedness and dignity due to pain, heavy sedation and physical restraint. Palliative care consultation services may mitigate poor outcomes. METHODS: From a dataset of 1440 ICU patients with ≥2 days of MV and ≥12 h of sustained wakefulness, we identified those at high risk of dying and/or who died and assessed patterns of sub-specialty palliative care consultation...
October 4, 2016: Heart & Lung: the Journal of Critical Care
Burke A Cunha, John Gian
BACKGROUND: Hospitalized adults with fever and "pneumonia" can be a difficult diagnostic challenge particularly when the clinical findings may be due to different infectious diseases. METHODS: We recently had an elderly female who presented with fever, fatigue and dry cough with elevated serum transaminases and lung infiltrates. The diagnosis of Epstein-Barr virus (EBV) infectious mononucleosis (IM) was made based on a positive Monospot test, elevated EBV VCA IgM titer, and highly elevated EBV viral load...
October 3, 2016: Heart & Lung: the Journal of Critical Care
Barbara DeVoe, Anita Roth, Gregory Maurer, Michal Tamuz, Martin Lesser, Renee Pekmezaris, Amgad N Makaryus, Alan Hartman, Paola DiMarzio
BACKGROUND: The Modified Early Warning Score (MEWS) helps identify patients experiencing a decline in physiological parameters that indicate risk for cardiac arrest (CA). OBJECTIVES: To assess the association between MEWS values and patient survival following in-hospital CA. METHODS: Retrospective cohort study of patients who experienced in-hospital CA. The relationship between CA survival and MEWS values as well as other risk factors such as age, gender and type of electrographic cardiac rhythms was analyzed using logistic regression...
October 1, 2016: Heart & Lung: the Journal of Critical Care
Said Ashraf, Alexandros Briasoulis, Luis Afonso
Cardiac sarcoidosis (CS) is found in 2-7% of patients with systemic sarcoidosis (SS). Its diagnosis and treatment is challenging, notwithstanding the poor prognosis and treatment. Hereby, we present a case of systemic sarcoidosis with rare cardiac manifestations of severe mitral incompetence and large coronary aneurysm in a previously healthy woman. She underwent successful mitral valve replacement and coronary artery bypass surgery and was maintained on low dose glucocorticoid therapy.
September 28, 2016: Heart & Lung: the Journal of Critical Care
Lani Zimmerman, Bunny Pozehl, Karen Vuckovic, Susan Barnason, Paula Schulz, Yaewon Seo, Catherine J Ryan, Julie J Zerwic, Holli A DeVon
The purpose of this review is to provide a guide for researchers and clinicians in selecting an instrument to measure four commonly occurring symptoms (dyspnea, chest pain, palpitations, and fatigue) in cardiac populations (acute coronary syndrome, heart failure, arrhythmia/atrial fibrillation, and angina, or patients undergoing cardiac interventions). An integrative review of the literature was conducted. A total of 102 studies summarizing information on 36 different instruments are reported in this integrative review...
September 26, 2016: Heart & Lung: the Journal of Critical Care
Ahmed N Mahmoud, Mohammad Al-Ani, Marwan Saad, Akram Y Elgendy, Islam Y Elgendy
BACKGROUND: Data regarding the characteristics associated with worse outcomes in Takotsubo syndrome (TTS) patients is lacking. METHODS AND OBJECTIVES: The National Inpatient Sample (NIS) 2012 database was utilized to calculate a risk score for in-hospital mortality following TTS that was internally and externally validated in both 2012 and 2013 databases, respectively. RESULTS: The incidences of in-hospital mortality in the 2012 development sample were 0...
September 24, 2016: Heart & Lung: the Journal of Critical Care
Antenor Rodrigues, Marianna Di Martino, Aline G Nellessen, Nidia A Hernandes, J Alberto Neder, Fabio Pitta
BACKGROUND: It is not yet completely known whether the 6MWT can be used to prescribe high-intensity exercise for patients with COPD. OBJECTIVE: To evaluate the ability of the six-minute walk test (6MWT) to prescribe high-intensity exercise for patients with chronic obstructive pulmonary disease (COPD). METHODS: Lung function, maximal inspiratory strength, symptoms and exercise capacity were evaluated in patients with COPD (n = 27) before and after a 12-week high-intensity exercise program...
September 14, 2016: Heart & Lung: the Journal of Critical Care
Patricia A Grady
Nursing science has a critical role to inform practice, promote health, and improve the lives of individuals across the lifespan who face the challenges of advanced cardiorespiratory disease. Since 1997, the National Institute of Nursing Research (NINR) has focused attention on the importance of palliative and end-of-life care for advanced heart failure and advanced pulmonary disease through the publication of multiple funding opportunity announcements and by supporting a cadre of nurse scientists that will continue to address new priorities and future directions for advancing palliative and end-of-life science in cardiorespiratory populations...
September 6, 2016: Heart & Lung: the Journal of Critical Care
Meagan Griffin, Desiree E Kosmisky, Megan A Templin, Toan Huynh, Lewis H McCurdy, Timothy R Pasquale, Kelly E Martin
PURPOSE: To determine if treating bronchoalveolar lavage (BAL) culture-positive patients with antifungal therapy impacted mortality compared to not treating due to presumed colonization. METHODS: We conducted a retrospective study of immunocompetent, critically ill adult patients from 2010 to 2014. Patients with a BAL culture-positive for Candida or unspeciated yeast and a clinical suspicion of pneumonia were included. The treatment group received an antifungal agent for at least 5 days, and the control group received either no antifungal therapy or an antifungal agent for less than 48 h...
September 3, 2016: Heart & Lung: the Journal of Critical Care
Wei-Chieh Lee, Chih-Yuan Fang, Huang-Chung Chen, Chien-Jen Chen, Cheng-Hsu Yang, Chi-Ling Hang, Hon-Kan Yip, Hsiu-Yu Fang, Chiung-Jen Wu
BACKGROUND: Limited data are available regarding the role of percutaneous cardiopulmonary support for the treatment of ST segment elevation myocardial infarction (STEMI) with profound cardiogenic shock (CS). The aim of this study is to identify the determinant factors for survival of patients with STEMI who underwent extracorporeal membrane oxygenation (ECMO) support. METHOD: From January 2005 to December 2013, 192 patients experienced STEMI with CS needed intra-aortic balloon pumping and support with vasoactive agents at our hospital...
September 3, 2016: Heart & Lung: the Journal of Critical Care
Barbara Riegel, Victoria Vaughan Dickson
OBJECTIVE: To explore factors contributing to intentional and unintentional medication nonadherence in adults with chronic heart failure (HF). BACKGROUND: Medication nonadherence is prevalent in HF but the factors contributing to it are not well understood. METHODS: This secondary data analysis of qualitative data explored narrative accounts about medication adherence from four previous studies (N = 112). The Necessity-Concerns-Framework derived from the Common Sense Model (CSM) of Self-Regulation guided the interpretation of themes...
September 2, 2016: Heart & Lung: the Journal of Critical Care
Alison E Turnbull, Sarina K Sahetya, Dale M Needham
OBJECTIVE: To develop a list of non-emergent, potentially harmful interventions commonly performed in ICUs that require a clear understanding of patients' treatment goals. BACKGROUND: A 2016 policy statement from the American Thoracic Society and American College of Critical Care Medicine calls on intensivists to engage in shared decision-making when "making major treatment decisions that may be affected by personal values, goals, and preferences." METHODS: A three-round modified Delphi consensus process was conducted via a panel of 6 critical care physicians, 6 ICU nurses, 6 former ICU patients, and 6 family members from 6 academic and community-based medical institutions in the U...
September 1, 2016: Heart & Lung: the Journal of Critical Care
Luiz Alberto Forgiarini, Antonio M Esquinas
No abstract text is available yet for this article.
September 1, 2016: Heart & Lung: the Journal of Critical Care
Hilary F Armstrong, David J Lederer, Matthew Bacchetta, Matthew N Bartels
BACKGROUND: Adults with primary graft dysfunction (PGD) after lung transplantation are at increased risk for pulmonary and functional impairment. No prior studies have described the long-term (within 1.5 years of transplant) cardiopulmonary exercise testing (CPET) results in adults with grade 3 PGD. The objective of this study was to compare the functional outcomes of lung transplant patients with and without grade 3 PGD via CPET and six-minute talk tests (6MWD). METHODS: 243 adults underwent lung transplantation between 2003 and 2010, 128 (53%) of whom underwent CPET and 6MWD within 12-18 months of transplantation...
September 1, 2016: Heart & Lung: the Journal of Critical Care
Qingmiao Shao, Tong Liu, Panagiotis Korantzopoulos, Zhiwei Zhang, Jianping Zhao, Guangping Li
BACKGROUND: Current evidence suggests that gaseous or particulate pollutants may increase the risk of atrial fibrillation (AF), although this association is still uncertain. METHODS: We conducted a systematic review of literature using PubMed, Ovid, Embase and Web of Science to identify studies reporting on the association between gaseous (ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide) or particulate matter 2.5 (PM2.5) and AF risk published until March 2015...
August 30, 2016: Heart & Lung: the Journal of Critical Care
Kate Hayes, Anne E Holland, Vincent A Pellegrino, Angeline S Leet, Louise M Fuller, Carol L Hodgson
OBJECTIVE: To describe physical function, leg complications and health-related quality of life (HRQOL) in the three months following extracorporeal membrane oxygenation (ECMO) pre- or post-heart transplantation (HTx). BACKGROUND: Little is known about functional recovery following ECMO before or after HTx. METHODS: A 2-year retrospective study in patients who received ECMO pre or post HTx. Strength, mobility, leg complications and HRQOL were recorded to hospital discharge...
August 23, 2016: Heart & Lung: the Journal of Critical Care
Elena Salmoirago-Blotcher, Lindsey Rosman, Ilan S Wittstein, Shira Dunsiger, Heather H Swales, Gerard P Aurigemma, Ira S Ockene
BACKGROUND: The role of psychological factors in the onset of takotsubo cardiomyopathy (TC) is still controversial. Associations with previous psychiatric conditions are registry-based; associations with personality characteristics and psychological sequelae of TC have been largely unexplored. This case-control study sought to study pre-admission psychiatric morbidity, personality traits, and post-discharge distress in incident cases of TC. METHODS: TC cases (Mayo clinic criteria) and acute myocardial infarction (MI) controls were recruited among women admitted to two Emergency Departments in New England...
August 20, 2016: Heart & Lung: the Journal of Critical Care
Margaret L Campbell, Katherine K Kero, Thomas N Templin
BACKGROUND: The Respiratory Distress Observation Scale(©) (RDOS) is a means for assessing respiratory distress when a patient is unable to give a dyspnea self-report. Cut-point determination was needed to guide clinical application. METHOD: A Receiver Operating Characteristic (ROC) curve analysis was conducted in a prospective, observation study with inpatients ranked by nurse practitioners (NP) into levels of respiratory distress. A research assistant simultaneously measured RDOS blinded to NP ranking...
August 2, 2016: Heart & Lung: the Journal of Critical Care
Margo A Halm
OBJECTIVE: To describe concerns, needs, strategies and advice of coronary artery bypass (CABG) caregivers during the first 3 months post-surgery. BACKGROUND: Nearly 400,000 patients underwent CABG surgery in 2010. While caregiving demand and difficulty has been investigated in early (4-8 weeks), mid (3 month), and later (6-12 months) recovery, no studies have explored early-to-mid concerns in-depth. METHODS: In this qualitative study, a purposive sample of CABG partners participated in structured interviews...
September 2016: Heart & Lung: the Journal of Critical Care
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