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Cardiovascular intensive care unit

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https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#1
Tom C Nguyen, Vinod H Thourani, Justin Q Pham, Yelin Zhao, Matthew D Terwelp, Prakash Balan, Daniel Ocazionez, Catalin Loghin, Richard W Smalling, Anthony L Estrera, Joseph Lamelas
OBJECTIVE: Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. METHODS: A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed...
January 17, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28096015/association-of-medication-errors-with-drug-classifications-clinical-units-and-consequence-of-errors-are-they-related
#2
Maki Muroi, Jay J Shen, Alona Angosta
Registered nurses (RNs) play an important role in safe medication administration and patient safety. This study examined a total of 1276 medication error (ME) incident reports made by RNs in hospital inpatient settings in the southwestern region of the United States. The most common drug class associated with MEs was cardiovascular drugs (24.7%). Among this class, anticoagulants had the most errors (11.3%). The antimicrobials was the second most common drug class associated with errors (19.1%) and vancomycin was the most common antimicrobial that caused errors in this category (6...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28093413/persistence-of-cardiac-remodeling-in-preadolescents-with-fetal-growth-restriction
#3
Sebastian Imre Sarvari, Merida Rodriguez-Lopez, Marta Nuñez-Garcia, Marta Sitges, Alvaro Sepulveda-Martinez, Oscar Camara, Constantine Butakoff, Eduard Gratacos, Bart Bijnens, Fatima Crispi
BACKGROUND: Fetal growth restriction (FGR) affects 5% to 10% of newborns and is associated with increased cardiovascular mortality in adulthood. We evaluated whether prenatal cardiovascular changes previously demonstrated in FGR persist into preadolescence. METHODS AND RESULTS: A cohort study of 58 FGR (defined as birth weight below 10th centile) and 94 normally grown fetuses identified in utero and followed-up into preadolescence (8-12 years of age) by echocardiography and 3-dimensional shape computational analysis...
January 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28089618/24-hour-protein-arginine-and-citrulline-metabolism-in-fed-critically-ill-children-a-stable-isotope-tracer-study
#4
Carlijn T I de Betue, Xiomara C Garcia Casal, Dick A van Waardenburg, Stephen M Schexnayder, Koen F M Joosten, Nicolaas E P Deutz, Marielle P K J Engelen
BACKGROUND & AIMS: The reference method to study protein and arginine metabolism in critically ill children is measuring plasma amino acid appearances with stable isotopes during a short (4-8 h) time period and extrapolate results to 24-h. However, 24-h measurements may be variable due to critical illness related factors and a circadian rhythm could be present. Since only short duration stable isotope studies in critically ill children have been conducted before, the aim of this study was to investigate 24-h appearance of specific amino acids representing protein and arginine metabolism, with stable isotope techniques in continuously fed critically ill children...
January 4, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28089084/predicting-the-need-for-intra-operative-large-volume-blood-transfusions-during-thoraco-abdominal-aortic-aneurysm-repair
#5
M Pieri, P Nardelli, M De Luca, G Landoni, S Frassoni, G Melissano, A Zangrillo, R Chiesa, F Monaco
OBJECTIVE: Thoraco-abdominal aortic aneurysm (TAAA) repair is a complex procedure performed in patients at high cardiovascular risk. High volume intra-operative bleeding is often recorded, and the amount of intra-operative blood product transfusion is associated with relevant morbidity and mortality. The aim of the study was to identify pre-operative predictors of intra-operative large volume blood transfusions (LVBT) to stratify patients pre-operatively. METHODS: This was a retrospective analysis of prospectively collected data of all patients who underwent open TAAA surgery at San Raffaele Scientific Institute from January 2009 to December 2015...
January 6, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28081339/management-of-acute-postoperative-hypertension-for-reducing-cardiovascular-complications-in-cancer-patients-when-and-how-aggressively
#6
Ning Lou, Daofeng Wang, Zhi Wang, Wenfeng Ye, Xiao Liu
BACKGROUND/AIM: We sought to determine what factors cardiovascular complications (CVCs) correlate with in cancer patients with acute postoperative hypertension (APH) and to define when and how aggressively to treat this disorder in the present study. MATERIALS AND METHODS: A retrospective observational study of cancer patients with postoperative hypertension at a single intensive care unit between July 2007 and June 2013 was conducted. The outcome of interest was the incidence of a CVC...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28072745/safety-and-efficacy-of-chloral-hydrate-for-conscious-sedation-of-infants-in-the-pediatric-cardiovascular-intensive-care-unit
#7
Mei-Lian Chen, Qiang Chen, Fan Xu, Jia-Xin Zhang, Xiao-Ying Su, Xiao-Zhen Tu
This study evaluates the safety and efficacy of chloral hydrate administration for the conscious sedation of infants in the pediatric cardiovascular intensive care unit (PCICU).We conducted a retrospective review of the charts of 165 infants with congenital heart disease who received chloral hydrate in our PCICU between January 2014 and December 2014. Chloral hydrate was administered orally or rectally to infants using doses of 50 mg/kg. We collected and analyzed relevant clinical parameters.The overall length of time to achieve sedation was ranged from 5 to 35 min (10...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28064413/journal-of-clinical-monitoring-and-computing-2016-end-of-year-summary-cardiovascular-and-hemodynamic-monitoring
#8
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...
January 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28051772/characterizing-teamwork-in-cardiovascular-care-outcomes-a-network-analytics-approach
#9
Matthew B Carson, Denise M Scholtens, Conor N Frailey, Stephanie J Gravenor, Emilie S Powell, Amy Y Wang, Gayle Shier Kricke, Faraz S Ahmad, R Kannan Mutharasan, Nicholas D Soulakis
BACKGROUND: The nature of teamwork in healthcare is complex and interdisciplinary, and provider collaboration based on shared patient encounters is crucial to its success. Characterizing the intensity of working relationships with risk-adjusted patient outcomes supplies insight into provider interactions in a hospital environment. METHODS AND RESULTS: We extracted 4 years of patient, provider, and activity data for encounters in an inpatient cardiology unit from Northwestern Medicine's Enterprise Data Warehouse...
November 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28042352/potentially-inappropriate-prescribing-andthe-risk-of-adverse-drug-reactions-in-critically-ill-older-adults
#10
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/28040411/emergency-department-critical-care-unit-for-critically-ill-cardiovascular-patients-an-observation-study
#11
Ken-Hui Fu, Yin-Ru Chen, Ju-Shin Fan, Yen-Chia Chen, Hsien-Hao Huang, Chorng-Kuang How, David Hung-Tsang Yen, Si-An Chen, Mu-Shun Huang
BACKGROUND: We investigated an intensive care model for acute critically cardiovascular emergency patients in the emergency department (ED) as compared with those in the coronary care unit (CCU) after ED visits. METHODS: We performed a retrospective cohort analysis of patients with acute cardiovascular emergency admitted to the intensive care unit in the ED (EICU) or CCU from January 1, 2010 to March 31, 2011 in an university-affiliated medical center. All clinical characteristics or predictors possibly related to in-hospital mortality were documented, completed, and measured via electronic medical records review...
December 28, 2016: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28035899/peripherally-administered-orexin-improves-survival-of-mice-with-endotoxin-shock
#12
Yasuhiro Ogawa, Yoko Irukayama-Tomobe, Nobuyuki Murakoshi, Maiko Kiyama, Yui Ishikawa, Naoto Hosokawa, Hiromu Tominaga, Shuntaro Uchida, Saki Kimura, Mika Kanuka, Miho Morita, Michito Hamada, Satoru Takahashi, Yu Hayashi, Masashi Yanagisawa
Sepsis is a systemic inflammatory response to infection, accounting for the most common cause of death in intensive care units. Here, we report that peripheral administration of the hypothalamic neuropeptide orexin improves the survival of mice with lipopolysaccharide (LPS) induced endotoxin shock, a well-studied septic shock model. The effect is accompanied by a suppression of excessive cytokine production and an increase of catecholamines and corticosterone. We found that peripherally administered orexin penetrates the blood-brain barrier under endotoxin shock, and that central administration of orexin also suppresses the cytokine production and improves the survival, indicating orexin's direct action in the central nervous system (CNS)...
December 30, 2016: ELife
https://www.readbyqxmd.com/read/28029346/practice-patterns-in-postoperative-echocardiographic-surveillance-after-congenital-heart-surgery-in-children-a-single-center-experience
#13
Alisa Arunamata, David M Axelrod, Alaina K Kipps, Doff B McElhinney, Andrew Y Shin, Frank L Hanley, Inger L Olson, Stephen J Roth, Elif Seda Selamet Tierney
OBJECTIVES: To review current institutional practice and describe factors contributing to variation in inpatient postoperative imaging surveillance after congenital heart surgery. STUDY DESIGN: We reviewed records of all children who underwent congenital heart surgery from June to December 2014. Number and primary indications for postoperative transthoracic echocardiograms (TTEs), providers involved, cardiovascular intensive care unit (CVICU) and total hospital length of stay, and Risk-Adjustment for Congenital Heart Surgery-1 scores were recorded...
October 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28028134/fibroblast-growth-factor-23-levels-associate-with-aki-and-death-in-critical-illness
#14
David E Leaf, Kirolos A Jacob, Anand Srivastava, Margaret E Chen, Marta Christov, Harald Jüppner, Venkata S Sabbisetti, Aline Martin, Myles Wolf, Sushrut S Waikar
Elevated plasma levels of the osteocyte-derived hormone fibroblast growth factor 23 (FGF23) have emerged as a powerful biomarker of cardiovascular disease and death in patients with CKD. Whether elevated urinary or plasma FGF23 levels are prospectively associated with AKI and death in critically ill patients is unknown. We therefore conducted a prospective cohort study of 350 critically ill patients admitted to intensive care units at an academic medical center to investigate whether higher urinary FGF23 levels associate with the composite end point of AKI or in-hospital mortality (AKI/death)...
December 27, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28024550/simulation-as-a-tool-to-ensure-competency-and-quality-of-care-in-the-cardiac-critical-care-unit
#15
REVIEW
Véronique Brunette, Nicolas Thibodeau-Jarry
Cardiac critical care units are high-risk clinical environments. Medical emergencies are frequent and require the intervention of a cohesive, efficient, and well trained interprofessional team. In modern clinical practice there is increased emphasis on safety but also increased lack of acceptance of medical errors and as a consequence, increased litigation. In the past decade, simulation-based learning has arisen as an effective and safe means to learn and practice acute care setting skills. It has been used and studied in different contexts including procedural skills training, crisis resource management and team training, patient and family member communication skills, and health care system quality improvement...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28011099/a-walking-program-for-people-with-severe-knee-osteoarthritis-did-not-reduce-pain-but-may-have-benefits-for-cardiovascular-health-a-phase-ii-randomised-controlled-trial
#16
J A Wallis, K E Webster, P Levinger, P J Singh, C Fong, N F Taylor
OBJECTIVE: The primary aim was to evaluate the effect of a dosed walking program on knee pain for patients with severe knee osteoarthritis (OA). Secondary aims evaluated the effects on cardiovascular health, function and quality of life. DESIGN: Participants with severe knee OA and increased cardiovascular risk were randomly assigned to a 12-week walking program of 70 min/week of at least moderate intensity, or to usual care. The primary outcome was knee pain (0-10)...
December 20, 2016: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28003694/the-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#17
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/27997877/effects-of-low-dose-atrial-natriuretic-peptide-infusion-on-cardiac-surgery-associated-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#18
Chieko Mitaka, Tetsu Ohnuma, Takanori Murayama, Fumio Kunimoto, Michio Nagashima, Tetsuhiro Takei, Naoya Iguchi, Makoto Tomita
PURPOSE: To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. MATERIALS AND METHODS: The Japanese trial for AKI in Post-cardiovascular surgery patients by ANP (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0...
December 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27995452/an-optimal-approach-for-laparoscopic-d3-lymphadenectomy-plus-complete-mesocolic-excision-d3-cme-for-right-sided-colon-cancer
#19
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/27994290/plasmapheresis-in-pediatric-intensive-care-unit
#20
Verica Misanovic, Danka Pokrajac, Smail Zubcevic, Admir Hadzimuratovic, Samra Rahmanovic, Selma Dizdar, Asmir Jonuzi, Edin Begic
INTRODUCTION: Plasmapheresis also known as a therapeutic plasma exchange (TPE) is extracorporeal procedure by which individual components of plasma that are harmful or blood cells can be removed from organism by using a blood separation technology. AIM: To present the results of the implementation of plasmapheresis in children in the Department of Pediatric Intensive Care of Pediatric Clinic, Clinical center of Sarajevo University, Bosnia and Herzegovina. PATIENTS AND METHODS: Research (period from December 2011 to June 2016) analyzed 66 plasmapheresis (11 patients-6 plasmapheresis per patient)...
October 2016: Medical Archives
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