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https://www.readbyqxmd.com/read/28647057/prevalence-of-obstructive-sleep-apnoea-in-acute-coronary-syndrome-routine-screening-in-intensive-coronary-care-units
#1
S Morra, F Bughin, K Solecki, M Aboubadra, B Lattuca, F Gouzi, J-C Macia, T-T Cung, S Cade, F Cransac, J-M Davy, Y Dauvilliers, D Corrado, F Roubille
INTRODUCTION: Increased evidence has shown that, despite the maximum care afforded to patients admitted with acute coronary syndromes (ACS), a residual risk of mortality remains, in which obstructive sleep apnoea (OSA) appears to be a largely undiagnosed factor, particularly in the intensive cardiac care unit (ICCU). The purpose of this study is to determine whether the systematic screening for sleep-disordered breathing (SDB) is feasible and may be recommended. The aims of our study are to determine: (1) The estimated prevalence of OSA in patients admitted to the ICCU for ACS determined by a validated, user-friendly portable screening device; (2) The feasibility of the screening in this context; (3) To assess any negative impact of OSA on the severity of ACS...
June 21, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28647051/longitudinal-nosocomial-outbreak-of-pseudomonas-fluorescens-bloodstream-infection-of-2-years-duration-in-a-coronary-care-unit
#2
Yuichiro Oba, Takahiro Nakajima, Chiyo Ogida, Miyuki Kawanami, Mamoru Fujiwara, Ikuko Matsumura
BACKGROUND: Outbreaks of bloodstream infections (BSI) of nonfermenting bacteria are a critical issue and often associated with hospital environments. We experienced a long-lasting outbreak of Pseudomonas fluorescens BSI limited to a coronary care unit (CCU). METHODS: We conducted a retrospective epidemiologic investigation and a case-control study for Pseudomonas fluorescens BSI from April 2011-July 2014. Environmental sample culture was conducted to detect the specific environmental source of transmission...
June 21, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28644157/ecg-case-of-the-month-chest-pain-and-ecg-abnormalities
#3
D Luke Glancy
A 27-year-old man was admitted to the coronary care unit because of chest pain and an electrocardiogram (ECG) read by the computer as an inferior infarct and left ventricular hypertrophy (Figure).
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28639987/antithrombotic-strategies-in-the-catheterization-laboratory-for-patients-with-acute-coronary-syndromes-undergoing-percutaneous-coronary-interventions-insights-from-the-employed-antithrombotic-therapies-in-patients-with-acute-coronary-syndromes-hospitalized
#4
Leonardo De Luca, Giuseppe Musumeci, Sergio Leonardi, Lucio Gonzini, Claudio Cavallini, Paolo Calabrò, Ciro Mauro, Luisa Cacciavillani, Stefano Savonitto, Stefano De Servi
AIMS: In the last decades, several new therapies have emerged for the treatment of acute coronary syndromes (ACS). We sought to describe real-world patterns of use of antithrombotic treatments in the catheterization laboratory for ACS patients undergoing percutaneous coronary interventions (PCI). METHODS: EmploYEd antithrombotic therapies in patients with acute coronary Syndromes HOspitalized in iTalian cardiac care units was a nationwide, prospective registry aimed to evaluate antithrombotic strategies employed in ACS patients in Italy...
July 20, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28635374/sepsis-favors-high-on-clopidogrel-platelet-reactivity
#5
Karolina Akinosoglou, Angelos Perperis, Spyridoula Theodoraki, Dimitrios Alexopoulos, Charalambos Gogos
High-on-treatment platelet reactivity (HPR) is associated with ischemic events in patients on antiplatelet therapy with a history of cardiovascular disease. On the other hand, recent data have associated sepsis with adverse cardiovascular events in patients admitted with bacteremia or respiratory infection. We aimed to assess P2Y12-mediated platelet reactivity (PR) during sepsis and recovery in patients under clopidogrel. This was a prospective observational study. Incoming patients presenting with signs/symptoms of sepsis already on a maintenance dose of clopidogrel of 75 mg qd for cardiovascular events were included in this study...
June 21, 2017: Platelets
https://www.readbyqxmd.com/read/28629228/use-of-provider-debriefing-to-improve-fast-track-extubation-rates-following-cardiac-surgery-at-an-academic-medical-center
#6
Jordan E Goldhammer, Jillian M Dashiell, Scott Davis, Marc C Torjman, Hitoshi Hirose
When used in appropriate patient populations, fast-track extubation (FTE) anesthetic techniques and intensive care unit (ICU) protocols safely reduce intubation times, ICU length of stay, and resource utilization. The authors hypothesized that perioperative provider debriefing on success or failure of FTE would improve FTE success. This retrospective observational study included consecutive patients undergoing elective coronary artery bypass graft (CABG), valve, or combined CABG/valve surgery between February 2015 and May 2016 (N = 313)...
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28618727/analysis-of-epidemiology-and-risk-factors-for-mortality-in-ventilator-associated-pneumonia-attacks-in-intensive-care-unit-patients
#7
Ayşe But, Meltem Arzu Yetkin, Dilek Kanyilmaz, Halide Aslaner, Aliye Baştuğ, Adalet Aypak, Pınar Öngürü, Esragül Akinci, Nevzat Mehmet Mutlu, Hürrem Bodur
BACKGROUND/AIM: The aim of this study was to investigate the epidemiologic characteristics, the causative microorganisms and their antimicrobial susceptibility patterns, and the prognostic risk factors for mortality in critically ill patients with ventilator-associated pneumonia (VAP). MATERIALS AND METHODS: In this retrospective observational study, all the critically ill patients with VAP hospitalized in a medical/surgical intensive care unit (ICU) between January 2010 and June 2015 were evaluated...
June 12, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28615229/cardiac-troponins-and-their-prognostic-importance-in-patients-with-suspected-acute-coronary-syndrome-and-renal-dysfunction
#8
Kai M Eggers, Bertil Lindahl, Juan J Carrero, Marie Evans, Karolina Szummer, Tomas Jernberg
BACKGROUND: Cardiac troponin (cTn) is important for risk assessment in patients with suspected acute coronary syndrome (ACS). cTn concentrations may, however, be affected by renal dysfunction, and the clinical importance of this interrelation is not well established. We investigated the association between cTnT and cTnI (measured with conventional assays and a more sensitive assay) with the estimated glomerular filtration rate (eGFR) and also assessed the ability of cTn to predict the 1-year all-cause mortality...
June 14, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28614421/zero-calcium-score-as-a-filter-for-further-testing-in-patients-admitted-to-the-coronary-care-unit-with-chest-pain
#9
Luis Cláudio Lemos Correia, Fábio P Esteves, Manuela Carvalhal, Thiago Menezes Barbosa de Souza, Nicole de Sá, Vitor Calixto de Almeida Correia, Felipe Kalil Beirão Alexandre, Fernanda Lopes, Felipe Ferreira, Márcia Noya-Rabelo
Background: The accuracy of zero coronary calcium score as a filter in patients with chest pain has been demonstrated at the emergency room and outpatient clinics, populations with low prevalence of coronary artery disease (CAD). Objective: To test the gatekeeping role of zero calcium score in patients with chest pain admitted to the coronary care unit (CCU), where the pretest probability of CAD is higher than that of other populations. Methods: Patients underwent computed tomography for calcium scoring, and obstructive CAD was defined by a minimum 70% stenosis on invasive angiography...
June 12, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28611187/comparing-outcomes-of-coronary-artery-bypass-grafting-among-large-teaching-and-urban-hospitals-in-china-and-the-united-states
#10
Zhe Zheng, Heng Zhang, Xin Yuan, Chenfei Rao, Yan Zhao, Yun Wang, Sharon-Lise Normand, Harlan M Krumholz, Shengshou Hu
BACKGROUND: Coronary artery disease is prevalent in China, with concomitant increases in the volume of coronary artery bypass grafting (CABG). The present study aims to compare CABG-related outcomes between China and the United States among large teaching and urban hospitals. METHODS AND RESULTS: Observational analysis of patients aged ≥18 years, discharged from acute-care, large teaching and urban hospitals in China and the United States after hospitalization for an isolated CABG surgery...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28606798/the-coronary-cardiac-care-unit-at-50-years-a-major-advance-in-the-practice-of-hospital-medicine
#11
EDITORIAL
William H Frishman, Joseph S Alpert, Thomas Killip
No abstract text is available yet for this article.
June 9, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28606503/optimizing-preoperative-expectations-leads-to-a-shorter-length-of-hospital-stay-in-cabg-patients-further-results-of-the-randomized-controlled-psy-heart-trial
#12
Charlotte J Auer, Johannes A C Laferton, Meike C Shedden-Mora, Stefan Salzmann, Rainer Moosdorf, Winfried Rief
OBJECTIVE: To examine the effect of a preoperative expectation-optimizing psychological intervention on length of stay in the hospital and time spent in the Intensive Care Unit (ICU) in patients undergoing elective cardiac surgery. METHODS: In a randomized controlled trial, 124 patients prior to undergoing coronary artery bypass grafting (CABG) or CABG combined with heart valve surgery were randomized to either a) standard medical care alone (SMC) or an additional preoperative intervention, b) an additional expectation manipulation intervention (EXPECT) to optimize patients' expectations, or c) an additional supportive therapy (SUPPORT), containing the same amount of therapeutic attention but without a specific focus...
June 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28605928/targeted-temperature-management-after-out-of-hospital-cardiac-arrest-in-three-young-patients
#13
Amina Godinjak, Amer Iglica, Adis Kukuljac, Ira Tančica, Selma Jusufović, Anes Ajanović, Šejla Rožajac
OBJECTIVE: We present the use of targeted temperature management in a tertiary-level intensive care unit, in three patients who experienced an out-of-hospital cardiac arrest. CASE REPORT: Three young patients experienced an out-of-hospital non-coronary cardiac arrest. The causes of the cardiac arrest were: Wolf-Parkinson-White syndrome, drug overdose and long-QT syndrome. All patients were resuscitated according to the advanced cardiac life support guidelines, and treated with targeted temperature management, with a target temperature of 33°C for 24 hours...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28602955/etiological-diagnoses-of-out-of-hospital-cardiac-arrest-survivors-admitted-to-the-intensive-care-unit-insights-from-a-french-registry
#14
Guillaume Geri, Olivier Passouant, Florence Dumas, Wulfran Bougouin, Benoit Champigneulle, Michel Arnaout, Jonathan Chelly, Jean-Daniel Chiche, Olivier Varenne, Lucie Guillemet, Frederic Pène, Victor Waldmann, Jean-Paul Mira, Eloi Marijon, Alain Cariou
BACKGROUND: Respective proportions of final etiologies are disparate in cohorts of cardiac arrest patients, depending on examined population and diagnostic algorithms. In particular, prevalence and characteristics of sudden unexplained death syndrome (SUDS) are debated. We aimed at describing etiologies in a large cohort of aborted out-of-hospital cardiac arrest (OHCA) patients, in order to assess prevalence and outcome of SUDS. PATIENTS AND METHODS: We analyzed data from our prospective registry of successfully resuscitated OHCA patients admitted to a cardiac arrest centre between January 2002 and December 2014...
June 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28601817/the-organisational-value-of-diagnostic-strategies-using-high-sensitivity-troponin-for-patients-with-possible-acute-coronary-syndromes-a-trial-based-cost-effectiveness-analysis
#15
Paul Jülicher, Jaimi H Greenslade, William A Parsonage, Louise Cullen
OBJECTIVES: To evaluate hospital-specific health economic implications of different protocols using high-sensitivity troponin I for the assessment of patients with chest pain. DESIGN: A cost prediction model and an economic microsimulation were developed using a cohort from a single centre recruited as part of the (ADAPT) trial, a prospective observational trial conducted from 2008 to 2011. The model was populated with 40 000 bootstrapped samples in five high-sensitivity troponin I-enabled algorithms versus standard care...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28598913/xenon-as-an-adjuvant-to-propofol-anesthesia-in-patients-undergoing-off-pump-coronary-artery-bypass-graft-surgery-a-pragmatic-randomized-controlled-clinical-trial
#16
Layth Al Tmimi, Sarah Devroe, Geertrui Dewinter, Marc Van de Velde, Gert Poortmans, Bart Meyns, Bart Meuris, Mark Coburn, Steffen Rex
BACKGROUND: Xenon was shown to cause less hemodynamic instability and reduce vasopressor needs during off-pump coronary artery bypass (OPCAB) surgery when compared with conventionally used anesthetics. As xenon exerts its organ protective properties even in subanesthetic concentrations, we hypothesized that in patients undergoing OPCAB surgery, 30% xenon added to general anesthesia with propofol results in superior hemodynamic stability when compared to anesthesia with propofol alone...
June 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28592276/different-strategies-for-mechanical-ventilation-during-cardiopulmonary-bypass-cpbvent-2014-study-protocol-for-a-randomized-controlled-trial
#17
Elena Bignami, Marcello Guarnieri, Francesco Saglietti, Enivarco Massimo Maglioni, Sabino Scolletta, Stefano Romagnoli, Stefano De Paulis, Gianluca Paternoster, Cinzia Trumello, Roberta Meroni, Antonio Scognamiglio, Alessandro Maria Budillon, Vincenzo Pota, Alberto Zangrillo, Ottavio Alfieri
BACKGROUND: There is no consensus on which lung-protective strategies should be used in cardiac surgery patients. Sparse and small randomized clinical and animal trials suggest that maintaining mechanical ventilation during cardiopulmonary bypass is protective on the lungs. Unfortunately, such evidence is weak as it comes from surrogate and minor clinical endpoints mainly limited to elective coronary surgery. According to the available data in the academic literature, an unquestionable standardized strategy of lung protection during cardiopulmonary bypass cannot be recommended...
June 7, 2017: Trials
https://www.readbyqxmd.com/read/28586614/frequency-indications-and-complications-of-pulmonary-artery-catheter-insertion-in-adult-open-heart-surgery-patients-of-a-tertiary-care-hospital
#18
Syed Shabbir Ahmed, Mohammad Irfan Akhtar, Rehana Kamal
OBJECTIVE: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28584794/correlations-between-high-platelet-reactivity-extent-of-coronary-artery-disease-and-periprocedural-myonecrosis-in-patients-with-acute-coronary-syndrome
#19
Kyeong Ho Yun, Jum Suk Ko, Jeong Mi Lee, Sang Jae Rhee
The purpose of the present study was to evaluate the correlations between high platelet reactivity (HPR) and the extent of coronary atherosclerosis and periprocedural myonecrosis in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). A total of 485 patients who underwent PCI for ACS was studied. HPR was defined as ≥230 platelet reactivity units (PRU) in point-of-care P2Y12 tested by the VerifyNow assay. The incidence of multi-vessel disease (MVD) was higher in patients with HPR than those with no HPR (56...
May 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/28584373/prospective-analysis-of-skin-findings-in-surgical-critically-ill-patients-intensive-care-unit
#20
Suzan Demir Pektas, Arzu Kahveci Demir
BACKGROUND: Intensive Care Units (ICUs) are places where critically ill patients are managed. AIM: We aimed to investigate skin disorders that developed in critically ill surgical patients during their stay in the ICU. METHODS: The prevalence of dermatological disorders and factors affecting their clinical features was prospectively analyzed in surgical ICU patients. We recorded age, sex, type of ICU, comorbidities, skin disorders, time to consultation, duration of ICU stay, and mortality rate...
May 2017: Indian Journal of Dermatology
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