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https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#1
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28792829/mental-health-problems-among-nurses-in-paediatric-cardiac-intensive-care
#2
Renata Santos Tito, Patrícia Campos Pavan Baptista, Fabio José da Silva, Vanda Elisa Andres Felli
At present, there are growing rates of psychiatric symptoms among some occupational categories, with emphasis on health professionals who work in hospitals. This study aimed to identify the occurrence of mental health problems (anxiety and depression) among 92 nursing workers in a paediatric cardiac intensive care unit. This is an exploratory, cross-sectional study, with a quantitative approach. The research was conducted in a public university hospital specialising in cardiology, pneumology, and thoracic and cardiac surgery...
August 10, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28569337/the-assessment-of-the-complexity-of-care-through-the-clinical-nursing-information-system-in-clinical-practice-a-study-protocol
#3
C Bravetti, A Cocchieri, F D'Agostino, R Alvaro, M Zega
BACKGROUND: The costs of nursing staff amounts to approximately 50% of the total budget of the health workforce and accounts for 20% to 30% of the total costs incurred by the health care companies. The goal of the study, by analyzing the complexity of care, is to provide a quantification of the assistance delivered, through the assessment of the technical aspects of the welfare activities according to the variable of time. Data from these activities flow into the clinical nursing information system Professional Assessment Instrument - PAI - which is used at the health facility involved in this study...
July 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/27989374/functional-quality-of-life-and-neurodevelopmental-outcomes-after-congenital-cardiac-surgery
#4
REVIEW
Megan L Ringle, Gil Wernovsky
Throughout the past few decades, advances in cardiology, neonatal intensive care, and surgical techniques have resulted in a growing cohort of thriving school-aged children with previously lethal complex congenital heart diseases. While survival has increased, there remains significant morbidity following repair including neurodevelopmental sequelae. Compared to children with a structurally normal heart, these infants and children have a higher frequency of abnormalities in tone, feeding, and delayed developmental milestones, as well as challenges with speech and learning disabilities, while a higher proportion of adolescents suffer from problems with processing speed, executive function, and a unique set of medical hardships related to exercise intolerance and obesity, medication burden, and mental health comorbidities...
December 2016: Seminars in Perinatology
https://www.readbyqxmd.com/read/27917566/perioperative-hypothermia-in-neonatal-intensive-care-unit-patients-effectiveness-of-a-thermoregulation-intervention-and-associated-risk-factors
#5
Branden M Engorn, Stephanie L Kahntroff, Karen M Frank, Sarabdeep Singh, Helen A Harvey, Charles T Barkulis, Annika M Barnett, Olamide O Olambiwonnu, Eugenie S Heitmiller, Robert S Greenberg
BACKGROUND: Hypothermia in neonatal intensive care unit patients is associated with morbidity. Perioperative normothermia is the standard of care. AIMS: We hypothesized that a quality improvement intervention (transport protocol, transport education, ongoing monitoring) would decrease the incidence of perioperative hypothermia. Secondarily, we hypothesized that patients undergoing surgery at a postmenstrual age of <37 weeks or at a weight of <1.5 kg would be at higher risk for perioperative hypothermia...
February 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27753765/risk-adjustment-for-congenital-heart-surgery-score-as-a-risk-factor-for-candidemia-in-children-undergoing-congenital-heart-defect-surgery
#6
Fabio de Araujo Motta, Libera Maria Dalla-Costa, Marisol Dominguez Muro, Andrea Lenzi, Gledson Luiz Picharski, Marion Burger
BACKGROUND: Candida species are the primary cause of invasive fungal infection in hospitalized children. There are few data on risk factors for postoperative candidemia in pediatric patients with congenital heart defects. This study aimed to identify risk factors for candidemia in patients with congenital heart defects who underwent cardiac surgery. METHODS: This was a case-control study conducted in patients admitted to a pediatric cardiology intensive care unit from January 2006 to December 2013...
November 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27701490/audit-of-availability-and-distribution-of-paediatric-cardiology-services-and-facilities-in-nigeria
#7
MULTICENTER STUDY
Ekanem N Ekure, Wilson E Sadoh, Fidelia Bode-Thomas, Adeola A Orogade, Adeola B Animasahun, Oluwatoyin O Ogunkunle, Iretiola Babaniyi, Maxwell U Anah, Barbara E Otaigbe, Adebiyi Olowu, Frances Okpokowuruk, Samuel I Omokhodion, Ogechi C Maduka, Uvie U Onakpoya, Daberechi K Adiele, Usman M Sani, Mustapha Asani, Christopher S Yilgwan, Queennette Daniels, Chinyere C Uzodimma, Chika O Duru, Mohammad B Abdulkadir, Joseph K Afolabi, John A Okeniyi
BACKGROUND: Paediatric cardiac services in Nigeria have been perceived to be inadequate but no formal documentation of availability and distribution of facilities and services has been done. OBJECTIVE: To evaluate and document the currently available paediatric cardiac services in Nigeria. METHODS: In this questionnaire-based, cross-sectional descriptive study, an audit was undertaken from January 2010 to December 2014, of the personnel and infrastructure, with their distributions according to geopolitical zones of Nigeria...
January 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27650214/causes-of-hospitalization-and-prognosis-in-patients-with-cardiovascular-diseases-secular-trends-in-the-years-2006-2014-according-to-the-silesian-cardiovascular-silcard-database
#8
Mariusz Gąsior, Damian Pres, Wojciech Wojakowski, Paweł Buszman, Zbigniew Kalarus, Michał Hawranek, Marek Gierlotka, Andrzej Lekston, Katarzyna Mizia-Stec, Marian Zembala, Lech Poloński, Michał Tendera
INTRODUCTION Despite the progress in cardiology in recent years, cardiovascular (CV) diseases remain the main cause of death in European countries. The knowledge concerning the structure of hospital admissions for CV diseases and clinical outcomes is fragmentary. OBJECTIVES The aim of the study was to analyze the characteristics and outcome of patients with CV disease, hospitalized between 2006 and 2014 and included in the Silesian Cardiovascular Database (SILCARD) covering a population of 4.6 million patients...
September 20, 2016: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/27583584/protocolized-care-for-early-shock-resuscitation
#9
Matthew Goodwin, Kaori Ito, Arielle H Gupta, Emanuel P Rivers
PURPOSE OF REVIEW: Protocolized care for early shock resuscitation (PCESR) has been intensely examined over the last decade. The purpose is to review the pathophysiologic basis, historical origin, clinical applications, components and outcome implications of PCESR. RECENT FINDINGS: PCESR is a multifaceted systems-based approach that includes early detection of high-risk patients and interventions to rapidly reverse hemodynamic perturbations that result in global or regional tissue hypoxia...
October 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27479258/-cardiac-evaluation-before-non-cardiac-surgery
#10
Jan Menzenbach, Olaf Boehm
Before non-cardiac surgery, evaluation of cardiac function is no frequent part of surgical treatment. European societies of anesthesiology and cardiology published consensus-guidelines in 2014 to present a reasonable approach for preoperative evaluation. This paper intends to differentiate the composite of perioperative risk and to display the guidelines methodical approach to handle it. Features to identify patients at risk from an ageing population with comorbidities, are the classification of surgical risk, functional capacity and risk indices...
July 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27476983/assessment-and-utility-of-frailty-measures-in-critical-illness-cardiology-and-cardiac-surgery
#11
REVIEW
Naheed Rajabali, Darryl Rolfson, Sean M Bagshaw
Frailty is a clearly emerging theme in acute care medicine, with obvious prognostic and health resource implications. "Frailty" is a term used to describe a multidimensional syndrome of loss of homeostatic reserves that gives rise to a vulnerability to adverse outcomes after relatively minor stressor events. This is conceptually simple, yet there has been little consensus on the operational definition. The gold standard method to diagnose frailty remains a comprehensive geriatric assessment; however, a variety of validated physical performance measures, judgement-based tools, and multidimensional scales are being applied in critical care, cardiology, and cardiac surgery settings, including open cardiac surgery and transcatheter aortic value replacement...
September 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27464285/-bleeding-in-patients-receiving-dual-antiplatelet-therapy-after-acute-coronary-syndrome-significance-prevention-and-interdisciplinary-management
#12
REVIEW
U Zeymer, J Koscielny, C von Heymann, M Spannagl, J Labenz, J Cremer, E Giannitsis, H Darius, F Goss
For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Premature discontinuation of dual antiplatelet therapy is associated with an increased risk of ischaemic events. However, antiplatelet therapy is also associated with an increased risk of bleeding that should not be under- or overestimated. To ensure an optimal care of patients receiving dual antiplatelet therapy after an acute coronary syndrome, an interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology gathered bleeding-related information and developed recommendations relevant to daily clinical practice...
July 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27294310/risk-adjustment-for-congenital-heart-surgery-score-as-a-risk-factor-for-candidemia-in-children-undergoing-congenital-heart-defect-surgery
#13
Fabio Araujo Motta, Libera Maria Dalla-Costa, Marisol Dominguez Muro, Andrea Lenzi, Gledson Luiz Picharski, Marion Burger
BACKGROUND: Candida species are the primary cause of invasive fungal infection in hospitalized children. There are few data on risk factors for postoperative candidemia in pediatric patients with congenital heart defects. This study aimed to identify risk factors for candidemia in patients with congenital heart defects who underwent cardiac surgery. METHODS: This was a case-control study conducted in patients admitted to a pediatric cardiology intensive care unit from January 2006 to December 2013...
June 10, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/26961569/pediatric-cardiology-boot-camp-description-and-evaluation-of-a-novel-intensive-training-program-for-pediatric-cardiology-trainees
#14
Scott R Ceresnak, David M Axelrod, Kara S Motonaga, Emily R Johnson, Catherine D Krawczeski
The transition from residency to subspecialty fellowship in a procedurally driven field such as pediatric cardiology is challenging for trainees. We describe and assess the educational value of a pediatric cardiology "boot camp" educational tool designed to help prepare trainees for cardiology fellowship. A two-day intensive training program was provided for pediatric cardiology fellows in July 2015 at a large fellowship training program. Hands-on experiences and simulations were provided in: anatomy, auscultation, echocardiography, catheterization, cardiovascular intensive care (CVICU), electrophysiology (EP), heart failure, and cardiac surgery...
June 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/26879087/experts-recommendations-for-the-management-of-cardiogenic-shock-in-children
#15
Olivier Brissaud, Astrid Botte, Gilles Cambonie, Stéphane Dauger, Laure de Saint Blanquat, Philippe Durand, Véronique Gournay, Elodie Guillet, Daniela Laux, Francis Leclerc, Philippe Mauriat, Thierry Boulain, Khaldoun Kuteifan
Cardiogenic shock which corresponds to an acute state of circulatory failure due to impairment of myocardial contractility is a very rare disease in children, even more than in adults. To date, no international recommendations regarding its management in critically ill children are available. An experts' recommendations in adult population have recently been made (Levy et al. Ann Intensive Care 5(1):52, 2015; Levy et al. Ann Intensive Care 5(1):26, 2015). We present herein recommendations for the management of cardiogenic shock in children, developed with the grading of recommendations' assessment, development, and evaluation system by an expert group of the Groupe Francophone de Réanimation et Urgences Pédiatriques (French Group for Pediatric Intensive Care and Emergencies)...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/26778900/physician-perceptions-and-recommendations-about-pre-hospital-emergency-medical-services-for-patients-with-st-elevation-acute-myocardial-infarction-in-abu-dhabi
#16
Edward L Callachan, Alawi A Alsheikh-Ali, Stevan Bruijns, Lee A Wallis
INTRODUCTION: Physician perceptions about emergency medical services (EMS) are important determinants of improving pre-hospital care for cardiac emergencies. No data exist on physician attitudes towards EMS care of patients with ST-Elevation Myocardial Infarction (STEMI) in the Emirate of Abu Dhabi. OBJECTIVES: To describe the perceptions towards EMS among physicians caring for patients with STEMI in Abu Dhabi. METHODS: We surveyed a convenience sample of physicians involved in the care of patients with STEMI (emergency medicine, cardiology, cardiothoracic surgery and intensive care) in four government facilities with 24/7 Primary PCI in the Emirate of Abu Dhabi...
January 2016: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/26714998/training-pathways-in-pediatric-cardiac-intensive-care-proceedings-from-the-10th-international-conference-of-the-pediatric-cardiac-intensive-care-society
#17
REVIEW
Vijay Anand, David M Kwiatkowski, Nancy S Ghanayem, David M Axelrod, James DiNardo, Darren Klugman, Ganga Krishnamurthy, Stephanie Siehr, Daniel Stromberg, Andrew R Yates, Stephen J Roth, David S Cooper
The increase in pediatric cardiac surgical procedures and establishment of the practice of pediatric cardiac intensive care has created the need for physicians with advanced and specialized knowledge and training. Current training pathways to become a pediatric cardiac intensivist have a great deal of variability and have unique strengths and weaknesses with influences from critical care, cardiology, neonatology, anesthesiology, and cardiac surgery. Such variability has created much confusion among trainees looking to pursue a career in our specialized field...
January 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/26442390/resident-implementation-of-the-2007-acc-aha-guidelines-on-preoperative-cardiac-evaluation-in-non-cardiac-surgery-patients-is-clinical-experience-enough
#18
Hassan H Amhaz, Ruth Kuo, Elie J Chidiac, Vinay Pallekonda, Samir F Fuleihan, George McKelvey, Romeo N Kaddoum
BACKGROUND: Preoperative evaluation of surgical patients is important, as perioperative complications are associated with increased mortality. Specialties including anesthesiology, internal medicine, cardiology, and surgery are involved in the evaluation and management of these patients. This institutional study investigated the residents' knowledge of the 2007 American College of Cardiology/American Heart Association (ACC/AHA) guidelines on perioperative evaluation of patients undergoing non-cardiac surgery...
June 2015: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/26157736/major-themes-for-2014-in-cardiothoracic-and-vascular-anaesthesia-and-intensive-care
#19
Jacob T Gutsche, Hynek Riha, Prakash Pate, Lance Atchley, Elizabeth Valentine, Ronak Shah, Sophia T Cisler, Stuart J Weiss, George Silvay, John G T Augoustides
There has been significant progress throughout 2014 in cardiothoracic and vascular anaesthesia and intensive care. There has been a revolution in the clinical approach to acute and chronic adult aortic diseases. Contemporary management of adult aortic disease is based on etiology, clinical presentation, extent, and integrated intervention with medical, endovascular and/or surgical measures. Further European guidelines have explored in depth the cardiovascular management in non-cardiac surgery with a thematic focus to reduce perioperative mortality from the leading offender, namely myocardial ischemia...
2015: Heart, Lung and Vessels
https://www.readbyqxmd.com/read/26152849/experts-recommendations-for-the-management-of-adult-patients-with-cardiogenic-shock
#20
Bruno Levy, Olivier Bastien, Bendjelid Karim, Karim Benjelid, Alain Cariou, Tahar Chouihed, Alain Combes, Alexandre Mebazaa, Bruno Megarbane, Patrick Plaisance, Alexandre Ouattara, Christian Spaulding, Christian Splaulding, Jean-Louis Teboul, Fabrice Vanhuyse, Thierry Boulain, Kaldoun Kuteifan
Unlike for septic shock, there are no specific international recommendations regarding the management of cardiogenic shock (CS) in critically ill patients. We present herein recommendations for the management of cardiogenic shock in adults, developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF)), with the participation the French Society of Anesthesia and Intensive Care (SFAR), the French Cardiology Society (SFC), the French Emergency Medicine Society (SFMU), and the French Society of Thoracic and Cardiovascular Surgery (SFCTCV)...
December 2015: Annals of Intensive Care
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