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Cardiovascular ICU

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https://www.readbyqxmd.com/read/28524035/-comparison-of-risk-of-death-between-older-and-non-older-critical-patients-in-icu-a-retrospective-cohort-study-of-consecutive-3-years
#1
Yeting Zhou, Daoming Tong, Shaodan Wang, Liansong Liu, Song Ye, Benwen Xu
OBJECTIVE: To investigate the risk of death between older and non-older critical patients in intensive care unit (ICU) in Shuyang People's Hospital. METHODS: A retrospective cohort study was conducted. The critical patients who aged 15 or above, and admitted to ICU of Shuyang People's Hospital from January 2014 to December 2016 were enrolled, and all the data was collected from the registration and electronic medical records in the ICU. The prevalence and causes of death in ICU critical patients during the study period were observed...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28498903/efficacy-and-safety-of-inhaled-anaesthetic-for-postoperative-sedation-during-mechanical-ventilation-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#2
J Spence, E Belley-Côté, H K Ma, S Donald, J Centofanti, S Hussain, S Gupta, P J Devereaux, R Whitlock
The aim was to evaluate the efficacy and safety of volatile anaesthetic for postoperative sedation in adult cardiac surgery patients through a systematic review and meta-analysis. We retrieved randomized controlled trials from MEDLINE, EMBASE, CENTRAL, Web of Science, clinical trials registries, conference proceedings, and reference lists of included articles. Independent reviewers extracted data, including patient characteristics, type of intraoperative anaesthesia, inhaled anaesthetic used, comparator sedation, and outcomes of interest, using pre-piloted forms...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28493896/candidemia-in-the-elderly-what-does-it-change
#3
Francesco Barchiesi, Elena Orsetti, Sara Mazzanti, Francesca Trave, Aldo Salvi, Cinzia Nitti, Esther Manso
BACKGROUND: Candidemia is a life-threatening fungal infection and it can affect patients of all ages. Characterization of candidemia in the elderly is lacking. METHODS: We performed a retrospective study of adults (≥ 18 years) with candidemia diagnosed in our center in 2010-2015. Demographics, comorbidities, clinical and microbiologic characteristics, antifungal treatment and outcome were compared between older (≤65 years) and younger (>65 years) patients...
2017: PloS One
https://www.readbyqxmd.com/read/28486385/validation-of-the-vasoactive-inotropic-score-in-pediatric-sepsis
#4
Amanda M McIntosh, Suhong Tong, Sara J Deakyne, Jesse A Davidson, Halden F Scott
OBJECTIVES: To assess the validity of Vasoactive-Inotropic Score as a scoring system for cardiovascular support and surrogate outcome in pediatric sepsis. DESIGN: Secondary retrospective analysis of a single-center sepsis registry. SETTING: Freestanding children's hospital and tertiary referral center. PATIENTS: Children greater than 60 days and less than 18 years with sepsis identified in the emergency department between January 2012 and June 2015 treated with at least one vasoactive medication within 48 hours of admission to the PICU...
May 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28468676/blood-pressure-deficits-in-acute-kidney-injury-not-all-about-the-mean-arterial-pressure
#5
Lui G Forni, Michael Joannidis
Acute kidney injury (AKI) is associated with increased morbidity and mortality. Although there are many causes of AKI, it is known that patients undergoing high-risk surgery are known to be at significant risk. Although much effort has centred on the minimum arterial pressure needed to maintain renal perfusion, this tends to be based on relatively crude measures such as the mean arterial pressure (MAP), which is widely used as an index for the optimal blood pressure. The rationale behind maintaining MAP is to provide adequate organ perfusion, although this is difficult to assess other than by applying crude end-points...
May 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28458554/patient-characteristics-associated-with-false-arrhythmia-alarms-in-intensive-care
#6
Patricia R Harris, Jessica K Zègre-Hemsey, Daniel Schindler, Yong Bai, Michele M Pelter, Xiao Hu
INTRODUCTION: A high rate of false arrhythmia alarms in the intensive care unit (ICU) leads to alarm fatigue, the condition of desensitization and potentially inappropriate silencing of alarms due to frequent invalid and nonactionable alarms, often referred to as false alarms. OBJECTIVE: The aim of this study was to identify patient characteristics, such as gender, age, body mass index, and diagnosis associated with frequent false arrhythmia alarms in the ICU. METHODS: This descriptive, observational study prospectively enrolled patients who were consecutively admitted to one of five adult ICUs (77 beds) at an urban medical center over a period of 31 days in 2013...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28450765/effect-of-body-mass-index-on-postoperative-complications-in-beating-coronary-artery-surgery
#7
Feridoun Sabzi, Reza Faraji
BACKGROUND: Body Mass Index (BMI) is considered as an important risk factor in cardiovascular surgery. We designed a historical cohort study for the evaluation of perioperative complications related to BMI in patients who underwent off-pump coronary artery bypass grafting (OPCAB). METHODS: We studied 1120 consecutive patients who underwent OPCAB between January 2008 and December 2011 in Imam Ali Hospital, Kermanshah, Iran. Patients were divided into four groups according to BMI: underweight/low BMI (< 18...
November 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28437365/a-method-to-account-for-variation-in-congenital-heart-surgery-length-of-stay
#8
Andrew Brennan, Kimberlee Gauvreau, Jean Connor, Melvin Almodovar, James DiNardo, Puja Banka, Meena Nathan, Derek Mathieu, Aditya Kaza, John E Mayer, Lisa Bergersen
OBJECTIVES: We sought to develop a risk-adjustment methodology for length of stay in congenital heart surgery, as none exist. DESIGN: Prospective cohort analysis combined with previously obtained retrospective cohort analysis of a Department of Cardiovascular Surgery clinical database. PATIENTS: Patients discharged from Boston Children's Hospital between October 1, 2006, and May 31, 2014, that underwent a congenital heart surgery procedure(s) linked to one of 103 surgical procedure types...
April 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28430755/differentiating-delirium-from-sedative-hypnotic-related-iatrogenic-withdrawal-syndrome-lack-of-specificity-in-pediatric-critical-care-assessment-tools
#9
Kate Madden, Michele M Burns, Robert C Tasker
OBJECTIVES: To identify available assessment tools for sedative/hypnotic iatrogenic withdrawal syndrome and delirium in PICU patients, the evidence supporting their use, and describe areas of overlap between the components of these tools and the symptoms of anticholinergic burden in children. DATA SOURCES: Studies were identified using PubMed and EMBASE from the earliest available date until July 3, 2016, using a combination of MeSH terms "delirium," "substance withdrawal syndrome," and key words "opioids," "benzodiazepines," "critical illness," "ICU," and "intensive care...
April 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28427779/fish-oil-lc-pufas-do-not-affect-blood-coagulation-parameters-and-bleeding-manifestations-analysis-of-8-clinical-studies-with-selected-patient-groups-on-omega-3-enriched-medical-nutrition
#10
Stephanie Jeansen, Renger F Witkamp, Jossie A Garthoff, Ardy van Helvoort, Philip C Calder
BACKGROUND & AIMS: The increased consumption of fish oil enriched-products exposes a wide diversity of people, including elderly and those with impaired health to relatively high amounts of n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFAs). There is an ongoing debate around the possible adverse effects of n-3 LC-PUFAs on bleeding risk, particularly relevant in people with a medical history of cardiovascular events or using antithrombotic drugs. METHODS: This analysis of 8 clinical intervention studies conducted with enteral medical nutrition products containing fish oil as a source of n-3 LC-PUFAs addresses the occurrence of bleeding-related adverse events and effects on key coagulation parameters (Prothrombin Time [PT], (activated) and Partial Thromboplastin Time [(a)PTT])...
March 29, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28427403/preoperative-carbohydrate-load-and-intraoperatively-infused-omega-3-polyunsaturated-fatty-acids-positively-impact-nosocomial-morbidity-after-coronary-artery-bypass-grafting-a-double-blind-controlled-randomized-trial
#11
Gibran Roder Feguri, Paulo Ruiz Lúcio de Lima, Danilo de Cerqueira Borges, Laura Ramos Toledo, Larissa Nadaf Batista, Thaís Carvalho E Silva, Neuber José Segri, José Eduardo de Aguilar-Nascimento
BACKGROUND: A strategy of limited preoperative fasting, with carbohydrate (CHO) loading and intraoperative infusion of omega-3 polyunsaturated fatty acids (ω-3 PUFA), has seldom been tried in cardiovascular surgery. Brief fasting, followed by CHO intake 2 h before anesthesia, may improve recovery from CABG procedures and lower perioperative vasoactive drug requirements. Infusion of ω-3 PUFA may reduce occurrences of postoperative atrial fibrillation (POAF) and shorten hospital stays...
April 20, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#12
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28412721/are-admission-procalcitonin-levels-universal-mortality-predictors-across-different-medical-emergency-patient-populations-results-from-the-multi-national-prospective-observational-triage-study
#13
Ramon Sager, Yannick Wirz, Devendra Amin, Adina Amin, Pierre Hausfater, Andreas Huber, Sebastian Haubitz, Alexander Kutz, Beat Mueller, Philipp Schuetz
BACKGROUND: Procalcitonin (PCT), an inflammatory blood biomarker, is well studied in infectious diseases. Its prognostic value in unselected emergency department (ED) patients remains yet undefined. Herein, we investigated association of admission PCT levels and mortality in a large, international-multicenter ED patient cohort. METHODS: We prospectively enrolled 6970 unselected, consecutive, adult, medical patients seeking ED care in three tertiary-care hospitals in Switzerland, France and the USA...
April 17, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#14
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 lifesaving. 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 under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28400408/incidence-and-risk-factors-for-cardiovascular-collapse-after-unplanned-extubations-in-the-pediatric-icu
#15
Paulo Sérgio Lucas da Silva, Marcelo Cunio Machado Fonseca
BACKGROUND: Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. METHODS: All children who had been mechanically ventilated for ≥12 h were prospectively tracked for UEs over an 8-y period. Subjects were included in the study if they were between ages 1 month and 16 y and had experienced UE...
April 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28397128/characteristics-and-treatment-of-patients-with-clinical-illness-due-to-synthetic-cannabinoid-inhalation-reported-by-medical-toxicologists-a-toxic-database-study
#16
Andrew A Monte, Diane P Calello, Roy R Gerona, Eike Hamad, Sharan L Campleman, Jeffery Brent, Paul Wax, Robert G Carlson
INTRODUCTION: Synthetic cannabinoid (SC) abuse has resulted in numerous outbreaks of severe clinical illness across the United States over the past decade. The primary objective of this study was to determine the clinical characteristics of patients abusing SC requiring bedside consultation by medical toxicologists. METHODS: This was a multicenter analysis from a prospectively collected cohort of patients presenting to medical care after synthetic cannabinoid exposure, utilizing the ToxIC Registry...
April 10, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/28379920/acute-kidney-injury-in-mechanically-ventilated-patients-the-risk-factor-profile-depends-on-the-timing-of-aki-onset
#17
Raúl Lombardi, Nicolás Nin, Oscar Peñuelas, Alejandro Ferreiro, Fernando Rios, Maria Carmen Marin, Konstantinos Raymondos, Jose A Lorente, Younsuck Koh, Javier Hurtado, Marco Gonzalez, Fekri Abroug, Manuel Jibaja, Yaseen Arabi, Rui Moreno, Dimitros Matamis, Antonio Anzueto, Andres Esteban
BACKGROUND.: Acute kidney injury (AKI) is a frequent complication in patients under mechanical ventilation (MV). We aimed to assess the risk factors for AKI with particular emphasis on those potentially preventable. STUDY DESIGN, SETTING AND PARTICIPANTS.: Retrospective analysis of a large, multinational database of MV patients with >24 hours of MV and normal renal function at admission. AKI was defined according to creatinine-based KDIGO criteria. Risk factors were analyzed according to the time point at which AKI occurred: early (≤48 hours after ICU admission, AKIE) and late (day 3 to day 7 of ICU stay, AKIL)...
April 4, 2017: Shock
https://www.readbyqxmd.com/read/28374265/both-high-and-low-plasma-glutamine-levels-predict-mortality-in-critically-ill-patients
#18
Takae Tsujimoto, Kentaro Shimizu, Nobuaki Hata, Tatsuya Takagi, Etsuko Uejima, Hiroshi Ogura, Masafumi Wasa, Takeshi Shimazu
PURPOSE: Plasma amino acids are important indicators for understanding human kinetics and amino acid dynamics. We aimed to investigate the association between the plasma glutamine levels and the mortality rates and determine whether plasma glutamine can predict the prognosis of critically ill patients. METHODS: The clinical records of adult patients who were admitted to an ICU were retrospectively evaluated to investigate the plasma levels of amino acids, including glutamine...
April 3, 2017: Surgery Today
https://www.readbyqxmd.com/read/28369234/postoperative-atrial-fibrillation-following-cardiac-surgery-a-persistent-complication
#19
Jason W Greenberg, Timothy S Lancaster, Richard B Schuessler, Spencer J Melby
Postoperative atrial fibrillation (POAF) is a common, expensive and potentially morbid complication following cardiac surgery. POAF occurs in around 35% of cardiac surgery cases and has a peak incidence on postoperative day 2. Patients who develop POAF incur on average $10 000-$20 000 in additional hospital treatment costs, 12-24 h of prolonged ICU time, and an additional 2 to 5 days in the hospital. POAF has been identified as an independent predictor of numerous adverse outcomes, including a 2- to 4-fold increased risk of stroke, reoperation for bleeding, infection, renal or respiratory failure, cardiac arrest, cerebral complications, need for permanent pacemaker placement, and a 2-fold increase in all-cause 30-day and 6-month mortality...
March 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28368919/a-national-perspective-on-ecmo-utilization-in-patients-with-burn-injury
#20
Lauren B Nosanov, Melissa M McLawhorn, Mariana Vigiola Cruz, Jason H Chen, Jeffrey W Shupp
Extracorporeal membranous oxygenation (ECMO) has become an increasingly utilized strategy to support patients in cardiac and cardiopulmonary failure. The Extracorporeal Life Support Organization reports adult survival rates between 40 and 50%. Utilization and outcomes for burned patients undergoing ECMO are poorly understood. The National Burn Repository (version 8.0) was queried for patients with ICD9 procedure codes for ECMO. Demographics, comorbidities, mechanism, injury details, and clinical outcomes were recorded...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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