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Cardiovascular ICU

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https://www.readbyqxmd.com/read/28203417/clinical-factors-associated-with-weaning-failure-in-patients-requiring-prolonged-mechanical-ventilation
#1
Hong-Joon Shin, Jin-Sun Chang, Seong Ahn, Tae-Ok Kim, Cheol-Kyu Park, Jung-Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yong-Soo Kwon
BACKGROUND: For patients requiring prolonged mechanical ventilation (PMV), weaning is difficult and mortality is very high. PMV has been defined recently, by consensus, as constituting ≥21 consecutive days of mechanical ventilation (MV) for ≥6 hours per day. This study aimed to evaluate the clinical factors predicting weaning failure in patients undergoing PMV in medical intensive care unit (ICU). METHODS: We retrospectively reviewed the clinical and laboratory characteristics of 127 patients who received MV for more than 21 days in the medical ICU at Chonnam National University Hospital in South Korea between January 2005 and December 2014...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#2
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28190429/the-scope-of-neurology-of-critical-illness
#3
E F M Wijdicks
Critical illness increases the probability of a neurologic complication. There are many reasons to consult a neurologist in a critically ill patient and most often it is altered alertness with no intuitive plausible explanation. Other common clinical neurologic problems facing the intensive care specialist and consulting neurologist in everyday decisions are coma following prolonged cardiovascular surgery, newly perceived motor asymmetry, seizures or other abnormal movements, and generalized muscle weakness...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28179097/octogenarian-donors-in-liver-transplantation-grant-an-equivalent-perioperative-course-than-ideal-young-donors
#4
Gianni Biancofiore, Maria Bindi, Davide Ghinolfi, Quirino Lai, Massimo Bisa, Massimo Esposito, Luca Meacci, Roberto Mozzo, Alicia Spelta, Franco Filipponi
BACKGROUND: Use of grafts from very old donors for liver transplantation is controversial. AIM: To compare the perioperative course of patients receiving liver grafts from young ideal vs octogenarian donors. METHODS: Analysis of the perioperative course of patients receiving liver grafts from young, ideal (18-39 years) vs octogenarian (≥80years) deceased donors between 2001 and 2014. RESULTS: 346 patients were studied: 179 (51...
January 21, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28164259/five-year-mortality-in-patients-treated-for-severe-community-acquired-pneumonia-a-retrospective-study
#5
H Lenz, G O Norby, V Dahl, T E Ranheim, R E Haagensen
BACKGROUND: The mortality rate in patients with severe community-acquired pneumonia (SCAP) is high. We investigated the 5-year mortality rate and causes of death in a patient population treated for SCAP in our intensive care unit (ICU), and compared the mortality rate in patients with or without chronic obstructive pulmonary disease (COPD) as comorbidity. METHODS: This retrospective study, which covers a period of 10 years, included patients aged > 18 years admitted to our ICU with SCAP as primary diagnosis and in need of mechanical ventilation for more than 24 h...
February 5, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28161384/hospitalization-costs-and-clinical-outcomes-in-cabg-patients-treated-with-intensive-insulin-therapy
#6
Saumeth Cardona, Francisco J Pasquel, Maya Fayfman, Limin Peng, Sol Jacobs, Priyathama Vellanki, Jeff Weaver, Michael Halkos, Robert A Guyton, Vinod H Thourani, Guillermo E Umpierrez
BACKGROUND: The financial impact of intensive (blood glucose [BG] 100-140mg/dl [5.5-7.8mM] vs. conservative (141-180mg/dl (7.9-10.0mM) glucose control in the ICU in patients, with and without diabetes, undergoing coronary artery bypass graft (CABG) surgery is not known. METHODS: This post-hoc cost analysis determined differences in hospitalization costs, resource utilization and perioperative complications in 288 CABG patients with diabetes (n=143) and without diabetes (n=145), randomized to intensive (n=143) and conservative (n=145) glucose control...
January 20, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28139304/development-and-implementation-of-a-comprehensive-multidisciplinary-emergency-department-extracorporeal-membrane-oxygenation-program
#7
Joseph E Tonna, Craig H Selzman, Michael P Mallin, Brigham R Smith, Scott T Youngquist, Antigoni Koliopoulou, Frederick Welt, Kathleen Diane Stoddard, Ram Nirula, Richard Barton, James Franklin Fair, James C Fang, Stephen McKellar
Despite advances in the medical and surgical management of cardiovascular disease, greater than 350,000 patients experience out-of-hospital cardiac arrest in the United States annually, with only a 12% neurologically favorable survival rate. Of these patients, 23% have an initial shockable rhythm of ventricular fibrillation/pulseless ventricular tachycardia (VF/VT), a marker of high probability of acute coronary ischemia (80%) as the precipitating factor. However, few patients (22%) will experience return of spontaneous circulation and sufficient hemodynamic stability to undergo cardiac catheterization and revascularization...
January 27, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28138011/systematic-review-of-%C3%AE-blocker-aspirin-and-statin-in-critically-ill-patients-importance-of-severity-of-illness-and-cardiac-troponin
#8
Florence G Rothenberg, Michael B Clay, Hina Jamali, Robin H Vandivier-Pletsch
Non-cardiac critically ill patients with type II myocardial infarction (MI) have a high risk of mortality. There are no evidence-based interventions to mitigate this risk. We systematically reviewed the literature regarding the use of medications known to reduce mortality in patients with cardiac troponin (cTn) elevation due to type I MI (β blockers, statin, and aspirin) in studies of critically ill patients without Type I MI. All PubMed publications between 1976-2/19/16 were reviewed. Search terms included: β blocker or aspirin or statin and intensive care unit (ICU) or critically ill or sepsis; 497 primary references were obtained...
January 30, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28135750/-ophthalmic-plastic-surgery-of-exposure-keratopathy-in-the-intensive-care-unit
#9
C Siebert, A Menges, F H Tost
Critically ill patients in the intensive care unit (ICU) may develop eye problems, due to impaired ocular protective mechanisms or direct involvement of the eye in severe systemic diseases. If eye infections or ocular surface disorders are not identified in time, endophthalmitis or corneal ulcer may develop and can cause permanent functional injuries of the eye. A retrospective analysis was performed and a total of 283 complete intensive care courses of treatment were evaluated, taking into account ophthalmic medical consultations for frequent cardinal symptoms...
January 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28121832/central-venous-to-arterial-co2-difference-after-cardiac-surgery-in-infants-and-neonates
#10
Leslie A Rhodes, W Clinton Erwin, Santiago Borasino, David C Cleveland, Jeffrey A Alten
OBJECTIVES: Venous to arterial CO2 difference correlates with cardiac output in critically ill adults, but its utility in pediatric patients is unclear. We sought to correlate venous to arterial CO2 difference with other cardiac output surrogates (arteriovenous oxygen saturation difference, central venous oxygen saturation, and lactate) and investigate its capacity to predict poor outcomes associated with low cardiac output (low cardiac output syndrome) in infants after cardiac surgery with cardiopulmonary bypass...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28110639/amitraz-poisoning-a-case-report-of-an-unusual-pesticide-poisoning-in-sri-lanka-and-literature-review
#11
H M M T B Herath, S P Pahalagamage, Nilukshana Yogendranathan, M D M S Wijayabandara, Aruna Kulatunga
BACKGROUND: Amitraz is a pesticide used worldwide on animals and in agriculture. It contains triazapentadiene, which is a centrally acting alpha-2 adrenergic agonist. Amitraz poisoning is fairly uncommon in humans and occurs via oral, dermal or inhalational routes. Only a limited number of case reports of human intoxication have been published and most of them are of accidental ingestion by children. CASE PRESENTATION: A twenty-year-old Sri Lankan female presented following self-ingestion of 20 ml of amitraz resulting in 37...
January 23, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28107263/the-severity-of-hypoxic-ischemic-encephalopathy-correlates-with-multiple-organ-dysfunction-in-the-hypothermia-era
#12
Miguel Alsina, Ana Martín-Ancel, Ana Alarcon-Allen, Gemma Arca, Francisco Gayá, Alfredo García-Alix
OBJECTIVES: The objectives are to 1) determine whether there is a positive correlation between the severity of hypoxic-ischemic encephalopathy and multiple organ dysfunction and 2) evaluate the organ dysfunction pattern in infants with hypoxic-ischemic encephalopathy in the hypothermia era. DESIGN: Retrospective observational study of prospective data collected between April 2009 and December 2012. SETTING: The study took place in the neonatal ICU of Hospital Sant Joan de Déu-Hospital Clínic of Barcelona...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28064413/journal-of-clinical-monitoring-and-computing-2016-end-of-year-summary-cardiovascular-and-hemodynamic-monitoring
#13
REVIEW
Bernd Saugel, Karim Bendjelid, Lester A Critchley, Steffen Rex, Thomas W L Scheeren
The assessment and optimization of cardiovascular and hemodynamic variables is a mainstay of patient management in the care for critically ill patients in the intensive care unit (ICU) or the operating room (OR). It is, therefore, of outstanding importance to meticulously validate technologies for hemodynamic monitoring and to study their applicability in clinical practice and, finally, their impact on treatment decisions and on patient outcome. In this regard, the Journal of Clinical Monitoring and Computing (JCMC) is an ideal platform for publishing research in the field of cardiovascular and hemodynamic monitoring...
February 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28042352/potentially-inappropriate-prescribing-andthe-risk-of-adverse-drug-reactions-in-critically-ill-older-adults
#14
Thamires B Galli, Wálleri C Reis, Vânia M Andrzejevski
BACKGROUND: Potentially inappropriate medication (PIM) use in the elderly is associated with increased risk of adverse drug reactions (ADRs), but there is limited information regarding PIM use in the intensive care unit (ICU) setting. OBJECTIVE: The aim of the study is to describe the prevalence and factors associated with the use of PIM and the occurrence of PIM-related adverse reactions in the critically ill elderly. METHODS: This study enrolled all critically ill older adults (60 years or more) admitted to medical or cardiovascular ICUs between January and December 2013, in a large tertiary teaching hospital...
October 2016: Pharmacy Practice
https://www.readbyqxmd.com/read/28042054/design-and-rationale-of-heart-and-lung-failure-pediatric-insulin-titration-trial-half-pint-a-randomized-clinical-trial-of-tight-glycemic-control-in-hyperglycemic-critically-ill-children
#15
Michael Sd Agus, Ellie Hirshberg, Vijay Srinivasan, Edward Vincent Faustino, Peter M Luckett, Martha Aq Curley, Jamin Alexander, Lisa A Asaro, Kerry Coughlin-Wells, Donna Duva, Jaclyn French, Natalie Hasbani, Martha T Sisko, Carmen L Soto-Rivera, Garry Steil, David Wypij, Vinay M Nadkarni
OBJECTIVES: Test whether hyperglycemic critically ill children with cardiovascular and/or respiratory failure experience more ICU-free days when assigned to tight glycemic control with a normoglycemic versus hyperglycemic blood glucose target range. DESIGN: Multi-center randomized clinical trial. SETTING: Pediatric ICUs at 35 academic hospitals. PATIENTS: Children aged 2weeks to 17years receiving inotropic support and/or acute mechanical ventilation, excluding cardiac surgical patients...
February 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28003694/the-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#16
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often life-saving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with a suboptimal evaluation of the airway and limited oxygen reserves despite adequate pre-oxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxaemia and cardiovascular collapse during TI in the ICU...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27995452/an-optimal-approach-for-laparoscopic-d3-lymphadenectomy-plus-complete-mesocolic-excision-d3-cme-for-right-sided-colon-cancer
#17
Daxing Xie, Chaoran Yu, Chun Gao, Hasan Osaiweran, Junbo Hu, Jianping Gong
BACKGROUND: It is common knowledge that high ligation of blood vessels at the D3 level and complete mesocolic excision (CME) are two critical points of right hemicolectomy for right colon cancer (RCC). (1-5) To date, a safe strategy for completing these two procedures under laparoscopic surgery has not been extensively described. The authors provide a video to demonstrate laparoscopic right hemicolectomy (D3 + CME) with an optimal mesentery-defined approach. By identifying three "tri-junctions," this approach facilitates dissection of the entire mesocolon along the embryologic planes as far centrally as possible and enables the high tie of feeding vessels at bifurcation...
December 19, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27978948/association-between-presence-of-a-cardiac-intensivist-and-mortality-in-an-adult-cardiac-care-unit
#18
Soo Jin Na, Chi Ryang Chung, Kyeongman Jeon, Chi-Min Park, Gee Young Suh, Joong Hyun Ahn, Keumhee C Carriere, Young Bin Song, Jin-Oh Choi, Joo-Yong Hahn, Jin-Ho Choi, Seung-Hyuk Choi, Young Keun On, Hyeon-Cheol Gwon, Eun-Seok Jeon, Duk-Kyung Kim, Jeong Hoon Yang
BACKGROUND: Dedicated intensive care unit (ICU) physician staffing is associated with a reduction in ICU mortality rates in general medical and surgical ICUs. However, limited data are available on the role of a cardiac intensivist in the cardiac intensive care unit (CICU). OBJECTIVES: This study investigated the association of cardiac intensivist-directed care with clinical outcomes in adult patients admitted to the CICU. METHODS: This study analyzed 2,431 patients admitted to the CICU at Samsung Medical Center in Seoul, South Korea, from January 2012 to December 2015...
December 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27965877/survivors-of-intensive-care-with-type-2-diabetes-and-the-effect-of-shared-care-follow-up-clinics-study-protocol-for-the-sweet-as-randomised-controlled-feasibility-study
#19
Yasmine Ali Abdelhamid, Liza Phillips, Michael Horowitz, Adam Deane
BACKGROUND: Many patients who survive the intensive care unit (ICU) experience long-term complications such as peripheral neuropathy and nephropathy which represent a major source of morbidity and affect quality of life adversely. Similar pathophysiological processes occur frequently in ambulant patients with diabetes mellitus who have never been critically ill. Some 25 % of all adult ICU patients have diabetes, and it is plausible that ICU survivors with co-existing diabetes are at heightened risk of sequelae from their critical illness...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27927246/minimally-invasive-oesophagectomy-versus-open-esophagectomy-for-resectable-esophageal-cancer-a-meta-analysis
#20
REVIEW
Waresijiang Yibulayin, Sikandaer Abulizi, Hongbo Lv, Wei Sun
BACKGROUND: Open esophagectomy (OE) is associated with significant morbidity and mortality. Minimally invasive oesophagectomy (MIO) reduces complications in resectable esophageal cancer. The aim of this study is to explore the superiority of MIO in reducing complications and in-hospital mortality than OE. METHODS: MEDLINE, Embase, Science Citation Index, Wanfang, and Wiley Online Library were thoroughly searched. Odds ratio (OR)/weighted mean difference (WMD) with a 95% confidence interval (CI) was used to assess the strength of association...
December 8, 2016: World Journal of Surgical Oncology
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