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Cardiovascular ICU

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https://www.readbyqxmd.com/read/29911033/association-between-glycemic-gap-and-adverse-outcomes-in-critically-ill-patients-with-diabetes
#1
Sandeep Donagaon, Mala Dharmalingam
Objectives: Glycemic excursions are commonly seen in patients admitted to the Intensive Care Unit (ICU) and are related to adverse outcomes. Glycemic gap is a marker of this excursion in patients with diabetes. It can be used to predict adverse outcomes in patients with diabetes admitted to the ICU. It is calculated by subtracting A1C-derived average glucose (ADAG) = ([28.7 × HbA1c]-46.7) from plasma glucose at admission. Objective of this study was to correlate glycemic gap and adverse outcomes in patients with type 2 diabetes mellitus (DM) admitted to the ICU...
March 2018: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29905897/patterns-of-injury-and-outcomes-in-the-elderly-patient-with-rib-fractures-a-multicenter-observational-study
#2
Mark G Van Vledder, Vicky Kwakernaak, Tjebbe Hagenaars, Esther M M Van Lieshout, Michiel H J Verhofstad
BACKGROUND: High rates of pneumonia and death have been reported among elderly patients with rib fractures. This study aims to identify patterns of injury and risk factors for pneumonia and death in elderly patients with rib fractures. METHODS: A retrospective multicenter observational study was performed using data registered in the national trauma registry between 2008 and 2015 in the South West Netherlands Trauma region. Data regarding demographics, mechanism of injury, pulmonary and cardiovascular history, pattern of extra-thoracic and intrathoracic injuries, ICU admission, length of stay, and morbidity and mortality following admission were collected...
June 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29902554/resource-use-during-the-last-6-months-of-life-among-copd-patients-a-population-level-study
#3
Kristof Faes, Joachim Cohen, Lieven Annemans
CONTEXT: Chronic obstructive pulmonary disease (COPD) patients often have several comorbidities, such as cardiovascular diseases (CVD) or lung cancer (LC), which might influence resource use in the final months of life. However, no previous studies documented resource use in end-of-life COPD patients at a population level, thereby differentiating whether COPD patients die of their COPD, CVD or LC. AIM: To describe end-of-life resource use in people diagnosed with COPD and compare this resource use between those dying of COPD, CVD and LC...
June 11, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29899389/calcitriol-trend-following-pediatric-cardiac-surgery-and-association-with-clinical-outcome
#4
Nina Acharya, Dermot R Doherty, Nick Barrowman, Gyaandeo Maharajh, Tara Girolamo, Katie O'Hearn, J Dayre McNally
BACKGROUND: Consistent with accepted practice in stable ambulatory populations, the majority of ICU research has evaluated vitamin D status using a single blood 25-hydroxyvitamin D (25(OH)D) level. Only a limited number of ICU studies have measured the active hormone, 1,25-dihydroxyvitamin D (calcitriol) and none have used change in calcitriol levels to evaluate axis functioning. The objective of this study was to describe the impact of Congenital Heart Disease (CHD) surgery on calcitriol levels and evaluate the relationship between change in postoperative levels and clinical course...
June 13, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29898577/nonpulmonary-risk-factors-of-acute-respiratory-distress-syndrome-in-patients-with-septic-bacteraemia
#5
Hyunseung Nam, Seung Hun Jang, Yong Il Hwang, Joo-Hee Kim, Ji Young Park, Sunghoon Park
Background/Aims: The relationship between nonpulmonary organ failure and the development of acute respiratory distress syndrome (ARDS) in patients with sepsis has not been well studied. Methods: We retrospectively reviewed the medical records of patients with septic bacteremia admitted to the medical intensive care unit (ICU) of a tertiary academic hospital between January 2013 and December 2016. Results: The study enrolled 125 patients of median age 73...
June 14, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29888089/predicting-mortality-in-diabetic-icu-patients-using-machine-learning-and-severity-indices
#6
Rajsavi S Anand, Paul Stey, Sukrit Jain, Dustin R Biron, Harikrishna Bhatt, Kristina Monteiro, Edward Feller, Megan L Ranney, Indra Neil Sarkar, Elizabeth S Chen
Diabetes constitutes a significant health problem that leads to many long term health issues including renal, cardiovascular, and neuropathic complications. Many of these problems can result in increased health care costs, as well risk of ICU stay and mortality. To date, no published study has used predictive modeling to examine the relative influence of diabetes, diabetic health maintenance, and comorbidities on outcomes in ICU patients. Using the MIMIC-III database, machine learning and binomial logistic regression modeling were applied to predict risk of mortality...
2018: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/29886666/-techniques-and-experience-which-improve-the-surgical-outcomes-of-critical-and-complex-congenital-heart-disease-in-neonates
#7
Y Pan, B Jia
Objective: To discuss the experience of early surgical intervention to critical and complex congenital heart diseases (CHD) in neonates. Methods: A retrospective study of clinical records of patients with congenital heart diseases underwent surgical intervention in one single pediatric cardiac center was performed. From January 2009 to December 2017, 841 critical and complex CHD neonates were identified at Department of Cardiovascular Surgery, Children's Hospital of Fudan University, of which 6.5% were premature...
June 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29850539/efficacy-of-statin-therapy-related-to-baseline-renal-function-in-patients-with-rheumatic-heart-disease-undergoing-cardiac-surgery
#8
Rongjun Zou, Wanting Shi, Jun Tao, Xifeng Lin, Dingwen Zhang, Songran Yang, Ping Hua
Background: Renal impairment increases the risk of cardiovascular events and perioperative complications in patients with heart valve disease. This study aimed to determine the perioperative benefit of statin treatment related to baseline renal function in patients with rheumatic heart disease (RHD) who had cardiac surgery. Methods and Results: We performed a retrospective study on 136 patients with RHD who underwent valve replacement surgery. The mean age of the patients was 56...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29802078/the-role-of-extra-pancreatic-infections-in-the-prediction-of-severity-and-local-complications-in-acute-pancreatitis
#9
Elizabeth Pando, Piero Alberti, Jimmy Hidalgo, Laura Vidal, Cristina Dopazo, Mireia Caralt, Laia Blanco, Concepción Gómez-Gavara, Itxarone Bilbao, Joaquim Balsells, Ramon Charco
BACKGROUND: The aim of our study was to determine the risk factors for extrapancreatic infection (EPI) occurrence and its predictive power for assessing severity and local complications in acute pancreatitis including infected pancreatic necrosis (IPN). METHODS: Clinical data of 176 AP patients prospectively enrolled were analysed. EPI analysed were bacteraemia, lung infection, urinary tract infection and catheter line infection. Risk factors analysed were: Leukocyte count, C-reactive protein, liver function test, serum calcium, serum glucose, Blood urea nitrogen, mean arterial pressure at admission, total parenteral nutrition (TPN), enteral nutrition, hypotension, respiratory, cardiovascular and renal failure at admission, persistent systemic inflammatory response (SIRS) and intrapancreatic necrosis...
May 19, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/29788912/association-between-troponin-i-levels-and-outcome-in-critically-ill-patients-admitted-to-non-cardiac-intensive-care-unit-with-high-prevalence-of-cardiovascular-risk-factors
#10
Abdulaleem Alatassi, Mohamad Habbal, Hani Tamim, Musharaf Sadat, Eman Al Qasim, Yaseen M Arabi
BACKGROUND: The association of troponin-I levels and outcome in medical-surgical ICU patients has been studied before in populations with low to moderate prevalence of cardiovascular risk factors. The objective in this article is to examine the association of troponin-I levels with hospital mortality in patients with high prevalence of cardiovascular risk factors who were admitted with medical-surgical indications to a non-cardiac intensive care unit. METHODS: This was a retrospective study of adult patients admitted to a tertiary medical-surgical ICU between July 2001 and November 2011...
May 22, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#11
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#12
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29750174/factors-affecting-the-length-of-stay-in-the-intensive-care-unit-our-clinical-experience
#13
Mehmet Toptas, Nilay Sengul Samanci, İbrahim Akkoc, Esma Yucetas, Egemen Cebeci, Oznur Sen, Mehmet Mustafa Can, Savas Ozturk
Background and Aim: Long hospital days in intensive care unit (ICU) due to life-threatening diseases are increasing in the world. The primary goal in ICU is to decrease length of stay in order to improve the quality of medical care and reduce cost. The aim of our study is to identify and categorize the factors associated with prolonged stays in ICU. Materials and Method: We retrospectively analyzed 3925 patients. We obtained the patients' demographic, clinical, diagnostic, and physiologic variables; mortality; lengths of stay by examining the intensive care unit database records...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29742584/predictive-validity-of-sepsis-3-definitions-and-sepsis-outcomes-in-critically-ill-patients-a-cohort-study-in-49-icus-in-argentina
#14
Elisa Estenssoro, Vanina S Kanoore Edul, Cecilia I Loudet, Javier Osatnik, Fernando G Ríos, Daniela N Vázquez, Mario O Pozo, Bernardo Lattanzio, Fernando Pálizas, Francisco Klein, Damián Piezny, Paolo N Rubatto Birri, Graciela Tuhay, Anatilde Díaz, Analía Santamaría, Graciela Zakalik, Arnaldo Dubin
OBJECTIVES: The new Sepsis-3 definitions have been scarcely assessed in low- and middle-income countries; besides, regional information of sepsis outcomes is sparse. Our objective was to evaluate Sepsis-3 definition performance in Argentina. DESIGN: Cohort study of 3-month duration beginning on July 1, 2016. SETTINGS: Forty-nine ICUs. PATIENTS: Consecutive patients admitted to the ICU with suspected infection that triggered blood cultures and antibiotic administration...
May 8, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29703040/electro-acupuncture-attenuates-inflammatory-responses-and-intraabdominal-pressure-in-septic-patients-a-randomized-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
Jian-Biao Meng, Yan-Na Jiao, Xiu-Juan Xu, Zhi-Zhen Lai, Geng Zhang, Chun-Lian Ji, Ma-Hong Hu
BACKGROUND: A pathological increase in intraabdominal pressure (IAP) and inflammatory responses have negative effects on splanchnic, respiratory, cardiovascular, renal, and neurological function in septic patients with intestinal dysfunction. Electro-acupuncture (EA) has been evidenced to have a bidirectional neuron-endocrine-immune system regulating effect in patients with intestinal dysfunction. The purpose of current study was to evaluate the effects of EA at "Zusanli" (ST36) and "Shangjuxu" (ST37) on inflammatory responses and IAP in septic patients with intestinal dysfunction manifested syndrome of obstruction of the bowels Qi...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29696106/evaluation-of-the-effect-of-aminophylline-in-reducing-the-incidence-of-acute-kidney-injury-after-cardiac-surgery
#16
Shahrbanoo Shahbazi, Peyman Alishahi, Elham Asadpour
Objectives: Acute renal failure is a common complication of major cardiovascular surgeries (One-third of patients). Adenosine release as a vascular vasodilator increases after cardiac surgery, which reduces renal and glomerular blood flow and subsequently causes kidney ischemic damage. The present study aimed at evaluating the impact of aminophylline as an adenosine receptor antagonist on renal function after cardiac surgery hoping to find an appropriate method to reduce acute kidney injury...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29687866/the-effect-of-transesophageal-echocardiography-in-the-surgical-treatment-of-tetralogy-of-fallot
#17
L-C Wang, S-K Li, F-T Zhu, T Bian, H-Y Wang
OBJECTIVE: To investigate the effect of transesophageal echocardiography (TEE) in the surgical treatment of tetralogy of Fallot. PATIENTS AND METHODS: 98 patients with tetralogy of Fallot received and cured by Zhengzhou Cardiovascular Hospital (Zhengzhou No. 7 People's Hospital) from January 2015 to January 2017 were selected as the study objects. All patients were examined by TEE before surgery, and the pulmonary artery index (PAI) and pulmonary vein index (PVI) were measured, so as to analyze the effect of TEE in the surgical treatment of tetralogy of Fallot...
April 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29686877/how-to-manage-various-arrhythmias-and-sudden-cardiac-death-in-the-cardiovascular-intensive-care
#18
REVIEW
Yoshinori Kobayashi
In the clinical practice of cardiovascular critical care, we often observe a variety of arrhythmias in the patients either with (secondary) or without (idiopathic) underlying heart diseases. In this manuscript, the clinical background and management of various arrhythmias treated in the CCU/ICU will be reviewed. The mechanism and background of lethal ventricular tachyarrhythmias vary as time elapses after the onset of MI that should be carefully considered to select a most suitable therapy. In the category of non-ischemic cardiomyopathy, several diseases are known to be complicated by the various ventricular tachyarrhythmias with some specific mechanisms...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29684773/late-organ-failures-in-patients-with-prolonged-intensive-care-unit-stays
#19
Elizabeth M Viglianti, Rachel Kramer, Andrew J Admon, Michael W Sjoding, Carol L Hodgson, Rinaldo Bellomo, Theodore J Iwashyna
PURPOSE: The purpose of this study was to characterize the organ failures that develop among patients with prolonged ICU stays, defined as those who spent a minimum of 14 days in an ICU. METHODS: We retrospectively studied a cohort of consecutive patients from a university hospital who were in an ICU for a minimum of 14 days during 2014-2016. We calculated daily Sequential Organ Failure Assessment (SOFA) scores from admission to ICU day 14. The primary outcome was the number of new late organ failures, defined as occurring on ICU day 4 through 14...
April 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29671149/biological-scoring-system-for-early-prediction-of-acute-bowel-ischemia-after-cardiac-surgery-the-palm-score
#20
Elie Zogheib, Cyril Cosse, Charles Sabbagh, Simon Marx, Thierry Caus, Marc Henry, Joseph Nader, Mathurin Fumery, Michael Bernasinski, Patricia Besserve, Faouzi Trojette, Cedric Renard, Pierre Duhaut, Said Kamel, Jean-Marc Regimbeau, Hervé Dupont
BACKGROUND: Bowel ischemia is a life-threatening emergency defined as an inadequate vascular perfusion leading to bowel inflammation resulting from impaired colonic/small bowel blood supply. Main issue for physicians regarding bowel ischemia diagnosis lies in the absence of informative and specific clinical or biological signs leading to delayed management, resulting in a poorer prognosis, especially after cardiac surgery. The aim of the present series was to propose a simple scoring system based on biological data for the diagnosis of bowel ischemia...
April 18, 2018: Annals of Intensive Care
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