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Cardiovascular intensive care unit

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
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
Yarelis Alvarado Reyes, Alexandra Perez, Gloria Rodriguez-Vega
OBJECTIVE: Vitamin D deficiency has been associated with increased risk and adverse outcomes in many clinical settings including cardiovascular disease, stroke, and critically ill patients. Therefore we aimed to determine whether vitamin D deficiency had any effect in aneurysmal subarachnoid hemorrhage (aSAH) clinical outcomes. METHODS: A retrospective record review was conducted in a tertiary community hospital in Puerto Rico. Adult patients admitted to the neurosurgical intensive care unit (NICU) with a diagnosis of aSAH from January 2013 to July 2014, who had a 25-hydroxyvitamin-D level drawn, were included...
October 15, 2016: World Neurosurgery
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Tetsurou Satoh, Osamu Isozaki, Atsushi Suzuki, Shu Wakino, Tadao Iburi, Kumiko Tsuboi, Naotetsu Kanamoto, Hajime Otani, Yasushi Furukawa, Satoshi Teramukai, Takashi Akamizu
Thyroid storm is an endocrine emergency which is characterized by multiple organ failure due to severe thyrotoxicosis, often associated with triggering illnesses. Early suspicion, prompt diagnosis and intensive treatment will improve survival in thyroid storm patients. Because of its rarity and high mortality, prospective intervention studies for the treatment of thyroid storm are difficult to carry out. We, the Japan Thyroid Association and Japan Endocrine Society taskforce committee, previously developed new diagnostic criteria and conducted nationwide surveys for thyroid storm in Japan...
October 15, 2016: Endocrine Journal
Agnieszka Ciarka, Lars H Lund, Johan Van Cleemput, Gabor Voros, Walter Droogne, Johan Vanhaecke
Heart transplantation (HT) recipients may have tachycardia secondary to cardiac denervation. As higher heart rate predicts worse outcomes in cardiovascular disease, we hypothesized that tachycardia and nonuse of β blockers are associated with increased mortality after HT. All patients who underwent HT at our institution from 1987 to 2010 were included. The association of heart rate 3 months after HT and β-blocker use during follow-up to mortality was assessed using Kaplan-Meier and multivariate Cox proportional hazards regression analyses adjusting for clinically relevant baseline variables...
September 15, 2016: American Journal of Cardiology
Nikolai Blanik, Konrad Heimann, Carina Pereira, Michael Paul, Vladimir Blazek, Boudewijn Venema, Thorsten Orlikowsky, Steffen Leonhardt
Vital parameter monitoring of term and preterm infants during incubator care with self-adhesive electrodes or sensors directly positioned on the skin [e.g. photoplethysmography (PPG) for oxygen saturation or electrocardiography (ECG)] is an essential part of daily routine care in neonatal intensive care units. For various reasons, this kind of monitoring contains a lot of stress for the infants. Therefore, there is a need to measure vital parameters (for instance respiration, temperature, pulse, oxygen saturation) without mechanical or conductive contact...
October 15, 2016: Biomedizinische Technik. Biomedical Engineering
Hui Wang, Yihua Bei, Peipei Huang, Qiulian Zhou, Jing Shi, Qi Sun, Jiuchang Zhong, Xinli Li, Xiangqing Kong, Junjie Xiao
Sepsis-induced myocardial dysfunction represents a major cause of death in intensive care units. Dysregulated microRNAs (miR)-155 has been implicated in multiple cardiovascular diseases and miR-155 can be induced by lipopolysaccharide (LPS). However, the role of miR-155 in LPS-induced cardiac dysfunction is unclear. Septic cardiac dysfunction in mice was induced by intraperitoneal injection of LPS (5 mg/kg) and miR-155 was found to be significantly increased in heart challenged with LPS. Pharmacological inhibition of miR-155 using antagomiR improved cardiac function and suppressed cardiac apoptosis induced by LPS in mice as determined by echocardiography, terminal deoxynucleotidyl transferase nick-end labeling (TUNEL) assay, and Western blot for Bax and Bcl-2, while overexpression of miR-155 using agomiR had inverse effects...
October 11, 2016: Molecular Therapy. Nucleic Acids
Samuel M Brown, Jeffrey Sorensen, Michael J Lanspa, Matthew T Rondina, Colin K Grissom, Sajid Shahul, V J Mathews
BACKGROUND: Septic shock is a common and often devastating syndrome marked by severe cardiovascular dysfunction commonly managed with vasopressors. Whether markers of heart rate complexity before vasopressor up-titration could be used to predict success of the up-titration is not known. METHODS: We studied patients with septic shock requiring vasopressor, newly admitted to the intensive care unit. We measured the complexity of heart rate variability (using the ratio of fractal exponents from detrended fluctuation analysis) in the 5 min before all vasopressor up-titrations in the first 24 h of an intensive care unit (ICU) admission...
October 10, 2016: BMC Infectious Diseases
Dominika Batycka-Stachnik, Agnieszka Piwoda, Tomasz Darocha, Malgorzata Spiewak, Sylweriusz Kosinski, Anna Jarosz, Hubert Hymczak, Tomasz Sanak, Robert Galazkowski, Jacek Piatek, Janusz Konstanty-Kalandyk, Rafal Drwila
: The objectives: To show and discuss the most frequent functional problems encountered in patients who underwent extracorporeal membrane oxygenation (ECMO) treatment after severe hypothermia and point out appropriate physiotherapy procedures used in order to diminish the effects of hypothermia on the human organism. It is necessary to look for effective physiotherapeutic solutions, especially that the number of scientific publications on the subject is very limited. DESIGN: Retrospective analysis Setting: Severe Accidental Hypothermia Center ( medical intensive care unit of a university hospital) Patients or participants: Nineteen patients who were qualified for ECMO in Severe Accidental Hypothermia Center Intervention: At least three times a day rehabilitation session (physiotherapeutic procedures adequate to patient problems) and interventions in case of emergency...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Milo Engoren, Michael D Maile, Michael Heung, Elizabeth S Jewell, Christie Vahabzadeh, Jonathan W Haft, Sachin Kheterpal
BACKGROUND: Acute kidney injury can be defined by a fall in urine output, and urine output criteria may be more sensitive in identifying acute kidney injury than traditional serum creatinine criteria. However, as pointed out in the Kidney Disease Improving Global Outcome guidelines, the association of urine output with subsequent creatinine elevations and death is poorly characterized. The purpose of this study was to determine what degrees of reduced urine output are associated with subsequent creatinine elevation and death...
October 4, 2016: Annals of Thoracic Surgery
Mindl M Messinger, Kimberly L Dinh, Erin J McDade, Brady S Moffett, Angus A Wilfong, Antonio G Cabrera
BACKGROUND: Advances in cardiac operations over the last few decades, including corrective operations in early life, have dramatically increased the survival of children with congenital heart disease. However, postoperative care has been associated with neurologic complications, with seizures being the most common manifestation. The primary objective of this study is to describe the outcomes in pediatric patients who received an antiepileptic drug (AED) post-cardiac surgery. METHOD: A retrospective cohort study was performed in all patients less than 18 years of age who received an AED in the cardiovascular intensive care unit at Texas Children's Hospital from June 2002 until June 2012...
July 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Sevil Özkan, Fatih Özdemir, Oğuz Uğur, Refik Demirtunç, Ahmet Yavuz Balci, Mehmet Kizilay, Ünsal Vural, Mehmet Kaplan, Ibrahim Yekeler
BACKGROUND: The metabolic syndrome (MS) is a clustering of factors that are associated with increased cardiovascular risk. A low-grade inflammatory process acts as the underlying pathophysiology, which suggests that the MS may have a detrimental effect on coronary interventions, including coronary artery bypass grafting (CABG) surgery performed with cardiopulmonary bypass (CPB). We aimed to evaluate the effect of the MS on morbidity and mortality rates in the early postoperative period in patients undergoing CABG...
July 13, 2016: Cardiovascular Journal of Africa
Duo Yang, Zeqiang Xie, Xuli Xin, Wenying Xue, Man Zhang
Mortality associated with infections due to carbapenem-resistant Klebsiella pneumoniae (CR-KP) is high and the infections need to be predicted early. The risk factors for CR-KP infection are heterogeneous. The aim of the present study was to construct a model allowing for the early prediction of CR-KP infection. Nosocomial infections due to K. pneumoniae were evaluated retrospectively over a 2-year period. The case cohort consisted of 370 inpatients with CR-KP infection. For each case enrolled, two matched controls with no CR-KP infection during their hospitalization were randomly selected...
October 2016: Biomedical Reports
Silvio A Ñamendys-Silva, Juan M Arredondo-Armenta, Humberto Guevara-García, Mireya Barragán-Dessavre, Francisco J García-Guillén, Luis A Sánchez-Hurtado, Bertha Córdova-Sánchez, Andoreni R Bautista-Ocampo, Angel Herrera-Gómez, Abelardo Meneses-García
We conducted an observational, longitudinal prospective study in which we measured the diameters of the inferior vena cava (IVC) of 47 patients using ultrasonography. The aim of our study was to assess the state of blood volume and to determine the percentage of patients who responded to intravascular volume expansion. Only 17 patients (36%) responded to fluid management. A higher number of responding patients had cardiovascular failure compared with nonresponders (82% vs. 50%, P = 0.03). Among the patients with cardiovascular failure, the probability of finding responders was 4...
October 2016: Proceedings of the Baylor University Medical Center
Laura Cluzol, Jennifer Cautela, Pierre Michelet, Antoine Roch, François Kerbaul, Julien Mancini, Marc Laine, Michael Peyrol, Floriane Robin, Franck Paganelli, Laurent Bonello, Franck Thuny
BACKGROUND: Acute heart failure (AHF) is a life-threatening medical emergency for which no new effective therapies have emerged in recent decades. No previous study has exhaustively described the entire course of care of AHF patients from first medical contact to hospital discharge or assessed its impact on prognosis. AIM: To fully describe the course of care and analyze its influence on outcomes in patients hospitalized with an AHF syndrome in an academic university center...
September 29, 2016: Archives of Cardiovascular Diseases
David Freiermuth, Berend Mets, Daniel Bolliger, Oliver Reuthebuch, Thomas Doebele, Markus Scholz, Michael Gregor, Matthias Haschke, Manfred Daniel Seeberger, Jens Fassl
OBJECTIVES: This study aimed to evaluate the pharmacokinetic profiles of sevoflurane and isoflurane during use of minimized extracorporeal circulation to perform coronary artery bypass graft surgery. Furthermore, cardiovascular stability during bypass and the postoperative release of troponins were evaluated. DESIGN: Prospective, randomized study. SETTING: University hospital. PARTICIPANTS: The study comprised 31 adult patients undergoing coronary artery bypass grafting...
July 12, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Aaron Heller, John Dollerschell, Joshua Burk, Hailey Haines, Jonathan Kozinn
BACKGROUND: In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported. OBJECTIVE: We describe a technique for safely decannulating the Avalon Elite VV-ECMO catheter at the bedside and assess the safety of this technique, as compared with the standard technique of decannulation in the operating room by a surgeon...
September 30, 2016: Anaesthesiology Intensive Therapy
Junxin Wang, Fang Chen, Santiago J Arconada-Alvarez, James Hartanto, Li-Peng Yap, Ryan Park, Fang Wang, Ivetta Vorobyova, Grant Dagliyan, Peter S Conti, Jesse V Jokerst
Heparin anticoagulation therapy is an indispensable feature of clinical care yet has a narrow therapeutic window and is the second most common intensive care unit (ICU) medication error. The active partial thromboplastin time (aPTT) monitors heparin but suffers from long turnaround times, a variable reference range, limited utility with low molecular weight heparin, and poor correlation to dose. Here, we describe a photoacoustic imaging technique to monitor heparin concentration using methylene blue as a simple and Federal Drug Administration-approved contrast agent...
September 28, 2016: Nano Letters
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
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