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Cardiovascular intensive care unit

Narjeet S Khurmi, Yu-Hui Chang, D Eric Steidley, Andrew L Singer, Winston R Hewitt, Kunam S Reddy, Adyr A Moss, Amit K Mathur
BACKGROUND: Cardiovascular disease (CVD) is a leading cause of post-liver transplant death, and variable care patterns may affect outcomes. We aimed to describe epidemiology and outcomes of inpatient CVD care across U.S. hospitals. METHODS: Using a merged dataset from the 2002-2011 Nationwide Inpatient Sample and the American Hospital Association Annual Survey, we evaluated liver transplant patients admitted primarily with myocardial infarction (MI), stroke (CVA), congestive heart failure (CHF), dysrhythmias, cardiac arrest (CA), or malignant hypertension...
March 15, 2018: Liver Transplantation
Gianni Casella, Maddalena Lettino
No abstract text is available yet for this article.
February 2018: Giornale Italiano di Cardiologia
Michael Goldfarb, Lior Bibas, L Kristin Newby, Timothy D Henry, Jason Katz, Sean van Diepen, Bojan Cercek
BACKGROUND: Quality indicators (QIs) are increasingly used in cardiovascular care as measures of performance but there is currently no consensus on indicators for the cardiovascular intensive care unit (CICU). METHODS: We searched Medline, CINAHL, EMBASE, and COCHRANE databases from inception until October 2016 and websites for organizations involved in quality measurement for QIs relevant to cardiovascular disease in an intensive or critical care setting. We surveyed 14 expert cardiac intensivist-administrators (7 European; 7 North American) on the importance and relevance of each indicator as a measure of CICU care quality using a scale of 1 (=lowest) to 10 (=highest)...
February 28, 2018: International Journal of Cardiology
Naomi Rahimi-Levene, Tomer Ziv-Baran, Victoria Peer, Ahuva Golik, Abraham Kornberg, Ronit Zeidenstein, Maya Koren-Michowitz
BACKGROUND: Transfusion guidelines advocate restrictive rather than liberal use of red blood cells (RBC) and are based mostly on randomized trials in intensive care and surgical departments. We aimed to study RBC transfusion practice in the medical patients' population. METHODS: The data in this study were collected from patients over the age of 18 years admitted to an Internal Medicine department between 2009 and 2014 who received at least one unit of packed red blood cells (RBC)...
2018: PloS One
Jesse Manunga, Timothy Sullivan, Ross Garberich, Peter Alden, Jason Alexander, Nedaa Skeik, Jessica Titus, Elliott Stephenson, Andrew Cragg
OBJECTIVE: The objective of this study was to evaluate outcomes of patients with complex abdominal aortic aneurysms (cAAAs) treated with open repair (OR) or fenestrated/branched endovascular aneurysm repair (F/B-EVAR) from a single center. METHODS: A retrospective analysis of consecutive patients with cAAAs treated electively by OR or F/B-EVAR between January 2010 and February 2017 was conducted. Demographics of the patients, cardiovascular risk factors, procedure time, number of vessels incorporated, radiation dose, estimated blood loss, intensive care unit (ICU) length of stay (LOS), and hospital LOS were recorded...
March 3, 2018: Journal of Vascular Surgery
Theodoros Aslanidis, Vasilios Grosomanidis, Konstantinos Karakoulas, Athanasios Chatzisotiriou
Electrodermal activity (EDA) is considered a measure of autonomous nervous system activity. This study performed an exploratory analysis of the EDA changes during blood pooling for arterial blood gas analysis in sedated adult critical care patients and correlated the variations to other monitored parameters. EDA, along with other parameters, were monitored during 4 h routine daytime intensive care nursing and treatment in an adult ICU. 4 h measurements were divided into two groups based upon the sedation level...
March 6, 2018: Medical Sciences: Open Access Journal
Nurdan Bedirli, Berrin Işık, Mehrnoosh Bashiri, Kutluk Pampal, Ömer Kurtipek
RATIONALE: Sugammadex is a cylodextrin derivate that encapsulates steroidal neuromuscular blocker agents and is reported as a safe and well-tolerated drug. In this case report, we present a patient who developed grade 3 anaphylaxis just after sugammadex administration. PATIENT CONCERNS: A 22-year-old woman with diagnosis of Weaver syndrome was scheduled for bilateral mammoplasty and resection of unilateral accessory breast tissue resection. Anesthesia was induced and maintained by propofol, rocuronium, and remifentanil...
January 2018: Medicine (Baltimore)
Wolf B Kratzert, Eva K Boyd, Johanna C Schwarzenberger
Survival of adults with congenital heart disease (CHD) has improved significantly over the last 2 decades, leading to an increase in hospital and intensive care unit (ICU) admissions of these patients. Whereas most of the ICU admissions in the past were related to perioperative management, the incidence of medical emergencies from long-term sequelae of palliative or corrective surgical treatment of these patients is rising. Intensivists now are confronted with patients who not only have complex anatomy after congenital cardiac surgery, but also complex pathophysiology due to decades of living with abnormal cardiac anatomy and diseases of advanced age...
November 16, 2017: Journal of Cardiothoracic and Vascular Anesthesia
John B C Tan, Danilo S Boskovic, Danilyn M Angeles
Premature neonates are in an energy deficient state due to (1) oxygen desaturation and hypoxia events, (2) painful and stressful stimuli, (3) illness, and (4) neurodevelopmental energy requirements. Failure to correct energy deficiency in premature infants may lead to adverse effects such as neurodevelopmental delay and negative long-term metabolic and cardiovascular outcomes. The effects of energy dysregulation and the challenges that clinicians in the Neonatal Intensive Care Unit (NICU) face in meeting the premature infant's metabolic demands are discussed...
March 2, 2018: Antioxidants (Basel, Switzerland)
Hitoshi Yamamura, Yu Kawazoe, Kyohei Miyamoto, Tomonori Yamamoto, Yoshinori Ohta, Takeshi Morimoto
Background: Use of high-dose norepinephrine is thought to have an immunosuppressive action that increases mortality. This study aimed to evaluate the correlation between norepinephrine dosage and prognosis of patients with septic shock. Methods: This study was a nested cohort of the DExmedetomidine for Sepsis in Intensive Care Unit Randomized Evaluation (DESIRE) trial. We evaluated 112 patients with septic shock and an initial Sequential Organ Failure Assessment Cardiovascular (SOFA-C) category score > 2 and initial lactate level > 2 mmol/L...
2018: Journal of Intensive Care
Adam M H Young, Joseph Donnelly, Xiuyun Liu, Mathew R Guilfoyle, Melvin Carew, Manuel Cabeleira, Danilo Cardim, Matthew R Garnett, Helen M Fernandes, Christina Haubrich, Peter Smielewski, Marek Czosnyka, Peter J Hutchinson, Shruti Agrawal
OBJECTIVE:  Although secondary insults such as raised intracranial pressure (ICP) or cardiovascular compromise strongly contribute to morbidity, a growing interest can be noticed in how the pre-hospital management can affect outcomes after traumatic brain injury (TBI). The objective of this study was to determine whether pre-hospital co-morbidity has influence on patterns of continuously measured waveforms of intracranial physiology after paediatric TBI. MATERIALS AND METHODS: Thirty-nine patients (mean age, 10 years; range, 0...
2018: Acta Neurochirurgica. Supplement
Azra Bihorac, Tezcan Ozrazgat-Baslanti, Ashkan Ebadi, Amir Motaei, Mohcine Madkour, Panagote M Pardalos, Gloria Lipori, William R Hogan, Philip A Efron, Frederick Moore, Lyle L Moldawer, Daisy Zhe Wang, Charles E Hobson, Parisa Rashidi, Xiaolin Li, Petar Momcilovic
MINI: In a single-center cohort of 51,457 adult surgical patients, we have developed and validated an automated machine-learning algorithm that uses existing clinical data in electronic health records to forecast the risk for major complications and death after any type of surgery with high sensitivity and high specificity. OBJECTIVE: To accurately calculate the risk for postoperative complications and death after surgery in the preoperative period using machine-learning modeling of clinical data...
February 27, 2018: Annals of Surgery
Soo Jin Na, Chi Ryang Chung, Hee Jung Choi, Yang Hyun Cho, Kiick Sung, Jeong Hoon Yang, Gee Young Suh, Kyeongman Jeon
BACKGROUND: The Extracorporeal Life Support Organization (ELSO) has suggested that extracorporeal membrane oxygenation (ECMO) patients should be managed by a multidisciplinary team. However, there are limited data on the impact of ECMO team on the outcomes of patients with severe acute respiratory failure. METHODS: All consecutive patients with severe acute respiratory failure who underwent ECMO for respiratory support from January 2012 through December 2016 were divided into the pre-ECMO team period (before January 2014, n = 70) and the post-ECMO team period (after January 2014, n = 46)...
February 27, 2018: Annals of Intensive Care
Yu Zhang, Li Jiang, Baomin Wang, Xiuming Xi
BACKGROUND: Although there were studies to investigate the risk factors for acute kidney injury (AKI) after surgery, most of them focused on one specific type of surgeries. The risk factors for postoperative AKI in patients undergoing all surgeries in intensive care units (ICU) have not been reported. METHODS: Data from 1731 patients undergoing surgery in 30 ICUs of 28 tertiary hospitals in Beijing from March to August 2012 were prospectively collected. AKI was defined and staged by the KDIGO criteria...
February 26, 2018: International Urology and Nephrology
Jennifer P Stevens, Tenzin Dechen, Richard Schwartzstein, Carl O'Donnell, Kathy Baker, Michael D Howell, Robert B Banzett
CONTEXT: Dyspnea is an uncomfortable and distressing sensation experienced by hospitalized patients. OBJECTIVES: There is no large-scale study of the prevalence and intensity of patient-reported dyspnea at the time of admission to the hospital. METHODS: Between March 2014 and September 2016, we conducted a prospective cohort study among all consecutive hospitalized patients at a single tertiary care center in Boston, MA. During the first 12 hours of admission to medical-surgical and obstetric units, nurses at our institution routinely collect a patient's (1) current level of dyspnea on a 0-10 scale with 10 anchored at "unbearable", (2) worst dyspnea in the past 24 hours prior to arrival at the hospital on the same 0-10 scale, and (3) what activities were associated with dyspnea prior to admission...
February 21, 2018: Journal of Pain and Symptom Management
Irma Isordia-Salas, José A Alvarado-Moreno, Rosa M Jiménez-Alvarado, Jesús Hernández-Juárez, David Santiago-Germán, Alfredo Leaños-Miranda, Abraham Majluf-Cruz
: The renin-angiotensin system plays an important role in the regulation of blood pressure and the development of coronary artery disease. The aim was to examine the association of the insertion deletion in the angiotensin-converting enzyme gene, M235T and T174M polymorphisms in the angiotensinogen gene with ST elevation acute myocardial infarction (STEAMI) in young Mexican population. We analyzed 242 unrelated patients with STEAMI 45 or less years of age, admitted to a cardiovascular intense care unit, and 242 individuals without STEAMI matched by age and sex, recruited from January 2006 and June 2013...
February 22, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Cecilia Villa Etchegoyen, Guillermo Alberto Keller, Sebastian Mrad, Sixuan Cheng, Guillermo DiGirolamo
Drug-induced QT interval prolongation is the most frequent cause of Long QT syndrome (LQTS) in the clinical practice. This electrophysiological entity, produced by an extended duration of the myocardial repolarization and reflected as a prolonged QT interval in the superficial electrocardiogram (EKG), increases the risk of polymorphic ventricular tachycardia (Torsades de Pointes) appearance and sudden death. Certain antiarrhythmic drugs such as amiodarone, sotalol, quinidine, procainamide, verapamil and diltiazem are known as drugs that, due to their mechanism of action, prolong the QT interval, demanding constant monitorization...
February 23, 2018: Current Clinical Pharmacology
Alberto Porta, Riccardo Colombo, Andrea Marchi, Vlasta Bari, Beatrice De Maria, Giovanni Ranuzzi, Stefano Guzzetti, Tommaso Fossali, Ferdinando Raimondi
This study checks whether autonomic markers derived from spontaneous fluctuations of heart period (HP) and systolic arterial pressure (SAP) and from their interactions with spontaneous or mechanical respiration (R) are associated with mortality in patients admitted to intensive care unit (ICU). Three-hundred consecutive HP, SAP and R values were recorded during the first day in ICU in 123 patients. Population was divided into survivors (SURVs, n = 83) and non-survivors (NonSURVs, n = 40) according to the outcome...
February 22, 2018: Scientific Reports
Ching-Yu Julius Chen, Tzu-Ching Yang, Christopher Chang, Shao-Chun Lu, Po-Yuan Chang
BACKGROUND: Homocysteine has been long considered a risk factor for atherosclerosis. However, cardiovascular events cannot be reduced through homocysteine lowering by B vitamin supplements. Although several association studies have reported an elevation of serum homocysteine levels in cardiovascular diseases, the relationship of homocysteine with ST-segment elevation myocardial infarction (STEMI) is not well established. METHODS: We prospectively enrolled STEMI patients who were consecutively admitted to an intensive care unit following coronary intervention in a single medical center in Taiwan...
February 13, 2018: BMC Cardiovascular Disorders
Wail Ali, Beth A Bubolz, Linh Nguyen, Danny Castro, Jorge Coss-Bu, Michael M Quach, Curtis E Kennedy, Anne E Anderson, Yi-Chen Lai
Objective: Convulsive status epilepticus can exert profound cardiovascular effects in adults including ventricular depolarization-repolarization abnormalities. Whether status epilepticus adversely affects ventricular electrical properties in children is less understood. Therefore, we sought to characterize ventricular alterations and the associated clinical factors in children following convulsive status epilepticus. Methods: We conducted a 2-year retrospective, case-control study...
December 2017: Epilepsia Open
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