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Decompensated Shock

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https://www.readbyqxmd.com/read/29754660/predictors-of-intra-aortic-balloon-pump-hemodynamic-failure-in-non-acute-myocardial-infarction-cardiogenic-shock
#1
Steven Hsu, Swetha Kambhampati, Christopher M Sciortino, Stuart D Russell, Steven P Schulman
OBJECTIVES: To characterize patient profile and hemodynamic profile of those undergoing intra-aortic balloon pump (IABP) for cardiogenic shock and define predictors of hemodynamic failure of IABP support. BACKGROUND: Clinical characteristics of IABP support in cardiogenic shock not related to acute myocardial infarction (AMI) remain poorly characterized. METHODS: We retrospectively studied a cohort of 74 patients from 2010 to 2015 who underwent IABP insertion for cardiogenic shock complicating acute decompensated heart failure not due to AMI...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29754648/the-cvad-registry-for-percutaneous-temporary-hemodynamic-support-a-prospective-registry-of-impella-mechanical-circulatory-support-use-in-high-risk-pci-cardiogenic-shock-and-decompensated-heart-failure
#2
George W Vetrovec, Mark Anderson, Theodore Schreiber, Jeffrey Popma, William Lombardi, Brijeshwar Maini, Jacob Eifer Moller, Andreas Schäfer, Simon R Dixon, Shelley Hall, E Magnus Ohman, Catalin Mindrescu, Jeffrey Moses, William O'Neill
Management of patients requiring temporary, mechanical hemodynamic support during high- risk percutaneous coronary intervention (PCI) or in cardiogenic shock is rapidly evolving. With the availability of the Impella 2.5, CP, 5.0, LD, and RP percutaneous mechanical circulatory support devices, there is a need for continued surveillance of outcomes. Three factors underline the importance of a registry for these populations. First, large randomized trials of hemodynamic support, involving cardiogenic shock, are challenging to conduct...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29745979/trends-etiologies-and-predictors-of-90-day-readmission-after-percutaneous-ventricular-assist-device-implantation-a-national-population-based-cohort-study
#3
Hafeez Ul Hassan Virk, Byomesh Tripathi, Shuchita Gupta, Akanksha Agrawal, Sandeep Dayanand, Faisal Inayat, Chayakrit Krittanawong, Ali Raza Ghani, Mohammad Nour Zabad, Parasuram Melarcode Krishnamoorthy, Aman Amanullah, Gregg Pressman, Christian Witzke, Sean Janzer, Jon George, Sanjog Kalra, Vincent Figueredo
Percutaneous ventricular assist devices (pVADs) are indicated to provide hemodynamic support in high-risk percutaneous interventions and cardiogenic shock. However, there is a paucity of published data regarding the etiologies and predictors of 90-day readmissions following pVAD use. We studied the data from the US Nationwide Readmissions Database (NRD) for the years 2013 and 2014. Patients with a primary discharge diagnosis of pVAD use were collected by searching the database for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedural code 37...
May 10, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29741481/urgent-balloon-aortic-valvuloplasty-in-patients-with-cardiogenic-shock-related-to-severe-aortic-stenosis-time-matters
#4
Nicolas Debry, Patrick Kone, Flavien Vincent, Gilles Lemesle, Cédric Delhaye, Guillaume Schurtz, Hugues Spillemaeker, Sina Porouchani, Augustin Coisne, Jean-Luc Auffray, Arnaud Sudre, Nicolas Lamblin, Laurent Bonello, Eric Van Belle
AIMS: To assess outcomes of balloon aortic valvuloplasty (BAV) as a rescue therapy in patients with cardiogenic shock (CS) related to severe aortic stenosis (AS). METHODS AND RESULTS: Forty-four consecutive patients, n=31 with hypotensive-CS (HCS) and n=13 with non-hypotensive CS (NHCS) due to acutely decompensated severe AS, from two centres were treated with emergency BAV. Composite primary endpoint was mortality or recurrent CS at 1-year follow-up. These patients (77...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29740793/immune-checkpoint-receptors-homeostatic-regulators-of-immunity
#5
REVIEW
Antonio Riva, Shilpa Chokshi
Alcoholic liver disease (ALD) is an escalating global problem accounting for more than 3 million deaths annually. Bacterial infections are diagnosed in 25-47% of hospitalized patients with cirrhosis and represent the most important trigger for acute decompensation, multi-organ failure, septic shock and death. Current guidelines recommend intensive antibiotic therapy, but this has led to the emergence of multi-drug resistant bacteria, which are associated with increased morbidity and mortality rates. As such, there is a pressing need to explore new paradigms for anti-infective therapy and host-directed immunomodulatory therapies are a promising approach...
May 8, 2018: Hepatology International
https://www.readbyqxmd.com/read/29730473/the-intensive-care-unit-icu-course-and-outcome-in-acute-on-chronic-liver-failure-are-comparable-to-other-populations
#6
Philippe Meersseman, Lies Langouche, Johannie du Plessis, Hannelie Korf, Michaël Mekeirele, Wim Laleman, Frederik Nevens, Alexander Wilmer, Greet Van den Berghe, Schalk W van der Merwe
BACKGROUND AND AIMS: Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of cirrhosis, development of organ failure and high short term mortality. Whether the outcome in ACLF patients admitted to the ICU with organ failure differs from other ICU populations is unknown. We compared the clinical course and host response in ICU patients with or without ACLF, matched for baseline severity of illness scores and characteristics. METHODS: From the large prospective EPaNIC randomized control trial database (n=4640), 133 patients were identified with cirrhosis of whom 71 fulfilled the CLIF criteria for ACLF...
May 3, 2018: Journal of Hepatology
https://www.readbyqxmd.com/read/29728116/implications-for-paediatric-shock-management-in-resource-limited-settings-a-perspective-from-the-feast-trial
#7
Kirsty Anne Houston, Elizabeth C George, Kathryn Maitland
BACKGROUND: Although the African "Fluid Expansion as Supportive therapy" (FEAST) trial showed fluid resuscitation was harmful in children with severe febrile illness managed in resource-limited hospitals, the most recent evidence reviewed World Health Organization (WHO) guidelines continue to recommend fluid boluses in children with shock according to WHO criteria "WHO shock", arguing that the numbers included in the FEAST trial were too small to provide reasonable certainty...
May 4, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29678608/clinical-and-hemodynamic-effects-of-intra-aortic-balloon-pump-therapy-in-chronic-heart-failure-patients-with-cardiogenic-shock
#8
Justin A Fried, Abhinav Nair, Koji Takeda, Kevin Clerkin, Veli K Topkara, Amirali Masoumi, Melana Yuzefpolskaya, Hiroo Takayama, Yoshifumi Naka, Daniel Burkhoff, Ajay Kirtane, S M Dimitrios Karmpaliotis, Jeffrey Moses, Paolo C Colombo, A Reshad Garan
BACKGROUND: The role of the intra-aortic balloon pump (IABP) in acute decompensated heart failure (HF) with cardiogenic shock (CS) is largely undefined. In this study we sought to assess the hemodynamic and clinical response to IABP in chronic HF patients with CS and identify predictors of response to this device. METHODS: We retrospectively reviewed all patients undergoing IABP implantation from 2011 to 2016 at our institution to identify chronic HF patients with acute decompensation and CS (cardiac index <2...
March 20, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29664889/transfer-status-a-significant-risk-factor-for-mortality-in-emergency-general-surgery-patients-requiring-colon-resection
#9
Michael P DeWane, Kimberly A Davis, Kevin M Schuster, Scott P Erwin, Adrian A Maung, Robert D Becher
BACKGROUND: Patients requiring emergency surgery have increased rates of morbidity and mortality. Transfer from outside institution delays effective control of ongoing infection and has been linked with worse outcomes. Previous research suggests transfer status negatively impacts survival but hasn't examined the effect of location and type of institution prior to transfer. This study aims to characterize the effect of type of transferring institution on postoperative outcomes after emergency colon surgery...
April 16, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29642755/successful-treatment-of-ventricular-arrhythmic-storm-with-percutaneous-coronary-intervention-and-catheter-ablation-in-a-patient-with-left-ventricular-assist-device
#10
Nihat Firat Sipahi, Arash Mehdiani, Diyar Saeed, Udo Boeken, Hisaki Makimoto, Artur Lichtenberg, Hannan Dalyanoglu
INTRODUCTION: Ventricular arrhythmias are common in patients with advanced heart failure, which may also persist after sufficient intensive therapy for heart failure even with a left ventricular assist device. Although most ventricular arrhythmias have no hemodynamic relevance during left ventricular assist device support, some patients suffer from right ventricular decompensation due to ventricular arrhythmias resulting in severe hemodynamic deterioration and poor clinical outcomes. METHODS: We describe herein an left ventricular assist device patient with refractory ventricular arrhythmic storm early after left ventricular assist device implantation...
April 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29577030/eus-guided-gall-bladder-drainage-in-severe-liver-disease-a-single-center-experience-in-critically-ill-cirrhotics
#11
Kapil Dev Jamwal, Manoj Kumar Sharma, Rakhi Maiwall, Barjesh Kumar Sharma, Shiv Kumar Sarin
Background and Aims : Acute calculous cholecystitis with impending gall bladder perforation in severe liver diseases including decompensated cirrhosis and acute-on-chronic liver failure (ACLF) is difficult to manage, due to the procedures such as cholecystectomy and per cutaneous cholecystostomy being associated with high risk and complications in these patients. Methods : Four cases of severe liver disease with acute calculous cholecystitis who presented to the Institute of Liver and Biliary Sciences (New Delhi, India) for further management were included in the study if they underwent endoscopic ultrasound-guided gall bladder drainage (EUS-GBD)...
March 28, 2018: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/29527717/outcomes-following-balloon-mitral-valvuloplasty-in-pregnant-females-with-mitral-stenosis-and-significant-sub-valve-disease-with-severe-decompensated-heart-failure
#12
Ajith Ananthakrishna Pillai, Chandramohan Ramasamy, Saranya Gousy V, Harichandrakumar Kottyath
BACKGROUND: Mitral stenosis may present with decompensated heart failure during pregnancy. Many patients do have advanced sub valve disease and present late with decompensated state. The outcomes of balloon mitral valvuloplasty (BMV) in such advanced sub valve disease with severe heart failure in pregnancy has not been specifically studied till now. METHODS: A descriptive study looking at the immediate and long-term outcomes of pregnant patients with MS who presented with severe heart failure and sub valve disease who had undergone BMV...
March 11, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29524230/transfusion-transmitted-malaria-masquerading-as-sickle-cell-crisis-with-multisystem-organ-failure
#13
Cheryl L Maier, Phillip J Gross, Christina L Dean, Satheesh Chonat, Andrew Ip, Morgan McLemore, Fuad El Rassi, Sean R Stowell, Cassandra D Josephson, Ross M Fasano
BACKGROUND: Fever accompanying vaso-occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion-transmitted malaria in a patient with SCD presenting with acute vaso-occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF). CASE REPORT: An 18-year-old African American male with SCD was admitted after multiple days of fever and severe generalized body pain...
March 9, 2018: Transfusion
https://www.readbyqxmd.com/read/29521654/diltiazem-associated-cardiogenic-shock-in-thyrotoxic-crisis
#14
Ahmed Subahi, Walid Ibrahim, Ashraf Abugroun
CLINICAL FEATURES: The patient we present is a 39-year-old woman with a history of hyperthyroidism who developed fast atrial fibrillation secondary to thyrotoxic storm. After the initiation of intravenous diltiazem drip, she developed hypotension, bradycardia, then asystole cardiac arrest. THERAPEUTIC CHALLENGE: It is well known that calcium channel blockers and beta blockers should be used with extreme caution if the patient with thyroid storm has decompensated heart failure with reduced ejection fraction...
February 28, 2018: American Journal of Therapeutics
https://www.readbyqxmd.com/read/29506838/safety-of-long-distance-transfers-of-patients-on-acute-mechanical-circulatory-support
#15
Tae Soo Kang, Byung Soo Ko, Stavros G Drakos, Josef Stehlik, Steven I Bott, Antigone Koliopoulou, Joseph E Tonna, Megan E Bowen, Kathleen Stoddard, Craig H Selzman, Stephen H McKellar
BACKGROUND: Acute mechanical circulatory support (aMCS) can be a lifesaving therapy for patients with refractory cardiogenic shock. As device safety and technology improve, so will the ability to extend aMCS to patients at remote hospitals. The Intermountain West is unique because of the large geographical area, making transport of critically ill patients a logistical challenge. METHODS: We reviewed our experience of transporting patients in cardiogenic shock over long distances who had already been placed on aMCS: Impella and extracorporeal membrane oxygenator devices...
April 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29465438/the-evolving-role-of-percutaneous-ventricular-assist-devices-in-high-risk-cardiac-patients
#16
Ilan A Marcuschamer, Aryeh Abelow, Ran Kornowski
The Impella is a mechanical circulatory support device that supports ventricular function. Since 2008, when the first Impella device received Food and Drug Administration clearance, its use has become increasingly prevalent. A variety of Impella devices are available, and are differentiated by size, power, and insertion techniques. These versions of the Impella have been used in a multitude of clinical scenarios, both emergent and elective, including high-risk coronary interventions, acute myocardial infarction complicated by cardiogenic shock, decompensated left and right heart failure, high-risk ventricular tachycardia ablations, and aortic valvuloplasty...
June 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29450594/position-paper-for-the-organization-of-ecmo-programs-for-cardiac-failure-in-adults
#17
Darryl Abrams, A Reshad Garan, Akram Abdelbary, Matthew Bacchetta, Robert H Bartlett, James Beck, Jan Belohlavek, Yih-Sharng Chen, Eddy Fan, Niall D Ferguson, Jo-Anne Fowles, John Fraser, Michelle Gong, Ibrahim F Hassan, Carol Hodgson, Xiaotong Hou, Katarzyna Hryniewicz, Shingo Ichiba, William A Jakobleff, Roberto Lorusso, Graeme MacLaren, Shay McGuinness, Thomas Mueller, Pauline K Park, Giles Peek, Vin Pellegrino, Susanna Price, Erika B Rosenzweig, Tetsuya Sakamoto, Leonardo Salazar, Matthieu Schmidt, Arthur S Slutsky, Christian Spaulding, Hiroo Takayama, Koji Takeda, Alain Vuylsteke, Alain Combes, Daniel Brodie
Extracorporeal membrane oxygenation (ECMO) has been used increasingly for both respiratory and cardiac failure in adult patients. Indications for ECMO use in cardiac failure include severe refractory cardiogenic shock, refractory ventricular arrhythmia, active cardiopulmonary resuscitation for cardiac arrest, and acute or decompensated right heart failure. Evidence is emerging to guide the use of this therapy for some of these indications, but there remains a need for additional evidence to guide best practices...
February 15, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29432453/clinical-findings-and-prognosis-of-patients-hospitalized-for-acute-decompensated-heart-failure-analysis-of-the-influence-of-chagas-etiology-and-ventricular-function
#18
Caíque Bueno Terhoch, Henry Fukuda Moreira, Silvia Moreira Ayub-Ferreira, Germano Emilio Conceição-Souza, Vera Maria Cury Salemi, Paulo Roberto Chizzola, Mucio Tavares Oliveira, Silvia Helena Gelas Lage, Edimar Alcides Bocchi, Victor Sarli Issa
AIMS: Explore the association between clinical findings and prognosis in patients with acute decompensated heart failure (ADHF) and analyze the influence of etiology on clinical presentation and prognosis. METHODS AND RESULTS: Prospective cohort of 500 patients admitted with ADHF from Aug/2013-Feb/2016; patients were predominantly male (61.8%), median age was 58 (IQ25-75% 47-66 years); etiology was dilated cardiomyopathy in 141 (28.2%), ischemic heart disease in 137 (27...
February 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29429457/-association-between-vasoactive-inotropic-score-and-prognosis-in-children-with-septic-shock
#19
Yan-Ran Qin, Cheng-Jun Liu, Feng Xu, Jing Li, Xiao-Yu Xiong
OBJECTIVE: To investigate the association between vasoactive-inotropic score (VIS) and prognosis in children with septic shock. METHODS: A total of 117 children with decompensated septic shock who received the treatment with vasoactive agents were enrolled. According to their prognosis, they were divided into death group with 41 children and survival group with 76 children. With the maximum VIS within the first 24 hours (24hVIS max) as the cut-off value (29.5), the children were divided into low VIS group with 78 children and high VIS group with 39 children...
February 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29329171/nonhuman-primate-rhesus-macaque-models-of-severe-pressure-targeted-hemorrhagic-and-polytraumatic-hemorrhagic-shock
#20
Forest R Sheppard, Antoni R Macko, Jacob J Glaser, Philip J Vernon, Alexander J Burdette, Ruth Madelaine Paredes, Craig A Koeller, Anthony E Pusateri, Douglas K Tadaki, Sylvain Cardin
BACKGROUND: We endeavored to develop clinically translatable nonhuman primate (NHP) models of severe polytraumatic hemorrhagic shock. METHODS: NHPs were randomized into five severe pressure-targeted hemorrhagic shock (PTHS) ± additional injuries scenarios: 30-min PTHS (PTHS-30), 60-min PTHS (PTHS-60), PTHS-60 + soft tissue injury (PTHS-60+ST), PTHS-60+ST + femur fracture (PTHS-60+ST+FF), and decompensated PTHS+ST+FF (PTHS-D). Physiologic parameters were recorded and blood samples collected at five time points with animal observation through T = 24 h...
February 2018: Shock
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