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Cardiovascular intensive care unit

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https://www.readbyqxmd.com/read/27907962/critical-care-of-traumatic-cervical-spinal-cord-injuries-preventing-secondary-injury
#1
Gary Schwartzbauer, Deborah Stein
The incidence of traumatic spinal cord injury (SCI) has not changed much over the years due to an aging population suffering falls, yet advances have been made in quality of life and survival time. In addition to initial medical and surgical stabilization, modern intensive care unit (ICU) care throughout the critical early period following SCI is essential to avoid continued secondary injury to the spinal cord. Cervical SCI patients are particularly prone and sensitive to periods of cardiovascular instability and respiratory failure directly resulting from their injuries...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907878/ultrasound-in-cardiac-trauma
#2
Theodosios Saranteas, Andreas F Mavrogenis, Christina Mandila, John Poularas, Fotios Panou
In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27902530/cardiac-troponin-release-is-associated-with-biomarkers-of-inflammation-and-ventricular-dilatation-during-critical-illness
#3
Marlies Ostermann, Salma Ayis, Emma Tuddenham, Jessica Lo, Katie Lei, John Smith, Barnaby Sanderson, Carl Moran, Paul Collinson, Janet Peacock, Andrew Rhodes, David Treacher
INTRODUCTION: Troponin release is common during critical illness. We hypothesized that there was an association between cardiac troponin T (cTnT) and biomarkers of systemic inflammation and ventricular dilatation. METHODS: In an observational prospective cohort study, we enrolled consecutive adult patients admitted for non-cardiac reasons to the Intensive Care Unit (ICU) in 2 tertiary care centers. We measured cTnT, C-reactive protein (CRP), Interleukin-6 (IL-6), procalcitonin (PCT) and N-terminal pro brain natriuretic peptide (NT-proBNP) daily in the first week, and on alternate days in the second week...
November 29, 2016: Shock
https://www.readbyqxmd.com/read/27895344/peri-operative-determinants-of-prolonged-cicu-stay-after-coronary-artery-bypass-graft-surgery-in-elderly-at-a-private-tertiary-care-hospital-a-case-control-study
#4
Fazal Wahab Khan, Shiraz Hashmi, Syed Saeed Naeem, Benish Fatima, Hashim Hanif, Mubashir Zareen, Saulat Hasnain Fatimi
OBJECTIVE: To explore peri-operative risk factors associated with prolonged stay in cardiac intensive care unit among patients undergoing isolated coronary artery bypass grafting. Methods: This retrospective case control study was conducted at the Aga Khan University Hospital, Karachi, comprised medical records of patients who had undergone cardiothoracic revascularisation surgery from January 2006 to December 2013. The patients were grouped into cases and controls at a ratio of 1:2 on the basis of length of stay at cardiac intensive care unit, i...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27861958/blood-transfusion-in-hematologic-intensive-care-unit
#5
Sylvain P Chantepie, Jean-Baptiste Mear, Jean-Jacques Parienti, Agnès Bazin, Khaled Benabed, Stéphane Cheze, Anne-Claire Gac, Hyacinthe Johnson-Ansah, Margaret Macro, Quentin Cabrera, Emilie Reboursiere, Charles Lancesseur, Gandhi Damaj, Oumedaly Reman
BACKGROUND: There is increasing evidence that excessive blood transfusion may be associated with impaired survival or cardiovascular events. One way to reduce the number of red blood cells (RBCs) is to transfuse 1 unit (1RBC) instead of 2 units of RBCs (2RBC). STUDY DESIGN AND METHODS: Patients requiring blood transfusions in hematologic intensive care unit were included in a prospective study using a single RBC unit per transfusion and were compared with an historical cohort who received 2 RBC units per transfusion...
November 11, 2016: Transfusion
https://www.readbyqxmd.com/read/27856076/hospital-wide-comparison-of-health-care-associated-infection-among-8-intensive-care-units-a-retrospective-analysis-for-2010-2015
#6
DongMei Yue, Caiping Song, Bo Zhang, Zhiyong Liu, Jin Chai, Yang Luo, Hao Wu
BACKGROUND: Exploring the distribution of nosocomial pathogens among different categories of intensive care units (ICUs) is critical to improving the management of health care-associated infection (HAI). Despite both single- and multicenter studies, the nature of the variations of HAIs within various ICUs remains inadequately evaluated. METHODS: Data on HAIs at our hospital during the period January 2010-December 2015 were collected from 8 ICUs, namely, respiratory, cardiovascular, neurology, neonatal, hematology, emergency, cardiothoracic surgery, and neurosurgery ICUs, at a tertiary hospital...
November 14, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27850123/483-postoperative-glycemic-control-in-a-cardiovascular-intensive-care-unit-beyond-the-insulin-infusion
#7
Maria Zhorne
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843912/are-intensive-cares-worthwhile-for-breast-cancer-patients-the-experience-of-an-oncological-icu
#8
Virginie Destrebecq, Ameye Lieveke, Thierry Berghmans, Marianne Paesmans, Jean-Paul Sculier, Anne-Pascale Meert
PURPOSE: One among seven women will present with breast cancer for which major therapeutic advances led to a significant increase in survival and cure rates. During or after cancer treatment, severe complications may occur requiring admission in intensive care unit (ICU). Intensivists could be reluctant for accepting cancer patients in the ICU, and there are very few data about causes of admission and prognosis of patients with breast cancer admitted in the ICU for an acute complication...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27829716/association-of-hyponatremia-with-in-hospital-outcomes-in-infective-endocarditis-a-5-year-review-from-an-indian-intensive-care-unit
#9
Saraschandra Vallabhajosyula, Muralidhar D Varma, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula
Hyponatremia is commonly noted with cardiovascular disorders, but its role in infective endocarditis (IE) is limited to being a marker of increased morbidity in IE patients with intravenous drug use. This was a 5-year retrospective review from an Indian Intensive Care Unit (ICU). Patients >18 years with IE and available serum sodium levels were included in the study. Pediatric and pregnant patients were excluded from the study. Hyponatremia was defined as admission sodium <135 mmol/L. Detailed data were abstracted from the medical records...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27829712/early-detection-of-nonneurologic-organ-failure-in-patients-with-severe-traumatic-brain-injury-multiple-organ-dysfunction-score-or-sequential-organ-failure-assessment
#10
Sara Ramtinfar, Shahrokh Yousefzadeh Chabok, Aliakbar Jafari Chari, Zoheir Reihanian, Ehsan Kazemnezhad Leili, Arsalan Alizadeh
OBJECTIVE: The aim of this study is to compare the discriminant function of multiple organ dysfunction score (MODS) and sequential organ failure assessment (SOFA) components in predicting the Intensive Care Unit (ICU) mortality and neurologic outcome. MATERIALS AND METHODS: A descriptive-analytic study was conducted at a level I trauma center. Data were collected from patients with severe traumatic brain injury admitted to the neurosurgical ICU. Basic demographic data, SOFA and MOD scores were recorded daily for all patients...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#11
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
: Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27821819/-effect-of-ultra-fast-track-extubation-in-cardiovascular-surgery
#12
Toshiro Kobayashi, Hiroshi Kurazumi, Hidenori Gohra, Seiichi Shibasaki, Yuko Kudo, Naoko Yamauchi, Takashi Tamura, Michio Shigedomi
Fast-track surgery has been widely implemented and allows such immediate extubation as in the operating room(OR). We retrospectively investigated the effect of routine ultra-fast-track(UFT) surgery extubating in the OR in patients undergoing cardiovascular operations. Among 333 consecutive patients, 224 (67.3%)were extubated in the OR. Five patients were re-intubated, but none were because of heart or respiratory failure. Independent predictors for failure of OR extubation were preoperative renal failure, pre-existent cerebrovascular disease, emergency surgery, and prolonged operation and/or cardiopulmonary bypass times...
November 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27818327/an-educational-intervention-optimizes-the-utilization-of-arterial-blood-gases-across-intensive-care-units-from-different-specialties-a-quality-improvement-study
#13
Carlos D Martínez-Balzano, Paulo Oliveira, Michelle O'Rourke, Luanne Hills, Andrés F Sosa
BACKGROUND: Arterial blood gas (ABG) overutilization leads to increased costs, inefficient use of staff work-hours, patient discomfort and blood loss. We developed guidelines to optimize ABG utilization in the intensive care unit (ICU). METHODS: ABG utilization guidelines were implemented on all adult ICUs in our institution: three medical, two trauma-surgery, one cardiovascular and one neurosurgical ICU. While relying on pulse oximetry, we encouraged the utilization of ABGs after an acute respiratory event or for a rational clinical concern, and discouraged obtaining ABGs for routine surveillance, after planned changes of PEEP or FiO2 on the mechanical ventilator, for spontaneous breathing trials, or when a disorder was not suspected...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27818120/efficacy-and-safety-of-prehospital-administration-of-unfractionated-heparin-enoxaparin-or-bivalirudin-in-patients-undergoing-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-insights-from-the-orbi-registry
#14
Vincent Auffret, Guillaume Leurent, Dominique Boulmier, Marc Bedossa, Amer Zabalawi, Jean-Philippe Hacot, Isabelle Coudert, Emmanuelle Filippi, Philippe Castellant, Antoine Rialan, Gilles Rouault, Philippe Druelles, Bertrand Boulanger, Josiane Treuil, Bertrand Avez, Marielle Le Guellec, Martine Gilard, Hervé Le Breton
BACKGROUND: Despite numerous studies in recent years, the best anticoagulant option for primary percutaneous coronary intervention (PCI) remains a matter of debate. AIMS: To compare in-hospital outcomes after prehospital administration of low-dose unfractionated heparin (UFH)±glycoprotein IIb/IIIa inhibitors (GPIs), enoxaparin±GPIs, or bivalirudin in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 1720 patients (median age 62...
November 3, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27816156/cardiac-lesions-in-the-critical-care-setting
#15
REVIEW
Manisha Gandhi, Amir A Shamshirsaz
The long-held belief that pregnancy is absolutely contraindicated in maternal cardiovascular disease is no longer justifiable using evidence-base medicine. There are some conditions in which pregnancy is contraindicated, and high maternal risk and poor fetal outcome can be predicted. However, in many women with heart disease, a more favorable maternal and fetal outcome is expected. This article focusses on the cardiac conditions that require more attention and have the potential to require observation in the intensive care unit setting...
December 2016: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/27806350/enteral-docosahexaenoic-acid-reduces-analgesic-administration-in-neonates-undergoing-cardiovascular-surgery
#16
Mariela Bernabe-Garcia, Mardia López-Alarcon, Alfredo Salgado-Sosa, Raul Villegas-Silva, Jorge Maldonado-Hernandez, Maricela Rodríguez-Cruz, Rodolfo Rivas-Ruiz, Luis Chavez-Sanchez, Francisco A Blanco-Favela, Javier Mancilla-Ramirez, Virginia Gordillo-Alvarez, Olivia Madrigal-Muñiz
BACKGROUND: Neonates undergoing surgery require analgesic medication to ameliorate acute pain. These medications produce negative side effects. Docosahexaenoic acid (DHA) has an antinociceptive effect in animals, but this has not been evaluated in human neonates. We evaluated the DHA effect on cumulative dose and duration of analgesics administered to neonates undergoing cardiovascular surgery. METHODS: A secondary analysis was performed with data from a clinical trial, in which enteral DHA was administered perioperatively compared with sunflower oil (SO)...
2016: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/27794361/the-vulnerable-microcirculation-in-the-critically-ill-pediatric-patient
#17
REVIEW
J W Kuiper, D Tibboel, C Ince
In neonates, cardiovascular system development does not stop after the transition from intra-uterine to extra-uterine life and is not limited to the macrocirculation. The microcirculation (MC), which is essential for oxygen, nutrient, and drug delivery to tissues and cells, also develops. Developmental changes in the microcirculatory structure continue to occur during the initial weeks of life in healthy neonates. The physiologic hallmarks of neonates and developing children make them particularly vulnerable during critical illness; however, the cardiovascular monitoring possibilities are limited compared with critically ill adult patients...
October 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27785087/adiponectin-treatment-attenuates-inflammatory-response-during-early-sepsis-in-obese-mice
#18
XianFeng Wang, Nancy L Buechler, Barbara K Yoza, Charles E McCall, Vidula Vachharajani
BACKGROUND: Morbid obesity increases the cost of care in critically ill patients. Sepsis is the leading cause of death in noncoronary intensive care units. Circulating cell-endothelial cell interactions in microcirculation are the rate-determining factors in any inflammation; obesity increases these interactions further. Adiponectin deficiency is implicated in increased cardiovascular risk in obese patients. We have shown that adiponectin deficiency increases microvascular dysfunction in early sepsis...
2016: Journal of Inflammation Research
https://www.readbyqxmd.com/read/27761033/role-of-melatonin-in-attenuation-of-haemodynamic-responses-to-laryngoscopy-and-intubation
#19
Priyamvada Gupta, Durga Jethava, Ruchika Choudhary, Dharam Das Jethava
BACKGROUND AND AIMS: Laryngoscopy and endotracheal intubation are considered as potent stimuli which lead to an increase in heart rate and blood pressure. Melatonin (N-acetyl-5-methoxytryptamine) has been studied for pre-operative anxiolysis and sedation in Intensive Care Unit. We made a hypothesis that melatonin can provide haemodynamic stability during laryngoscopy and intubation when given 120 min before the procedure. METHODS: Sixty American Society of Anesthesiologists physical status Grade I and II patients of either gender, 20-45 years old, 40-65 kg body weight, scheduled to undergo elective surgical procedures under general anaesthesia were assigned into two equal groups - Group C (control) and Group M (melatonin)...
October 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27756811/risk-factors-for-hypoxemia-following-surgical-repair-of-acute-type-a-aortic-dissection
#20
Nan Liu, Wei Zhang, Weiguo Ma, Wei Shang, Jun Zheng, Lizhong Sun
OBJECTIVES: To identify the risk factors for hypoxaemia following surgical repair of acute type A aortic dissection. METHODS: This was a retrospective study of patients treated between October 2013 and December 2014 at the Department of Cardiovascular Surgery, Anzhen Hospital, China. Univariable and multivariable analyses were performed on the clinical data of 160 patients with acute type A dissection and who underwent ascending aortic and arch replacement under deep hypothermic circulatory arrest...
October 17, 2016: Interactive Cardiovascular and Thoracic Surgery
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