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Cardiovascular intensive care unit

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https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#1
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
July 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#2
Pranas Serpytis, Petras Navickas, Alvydas Navickas, Rokas Serpytis, Giedrius Navickas, Sigita Glaveckaite
BACKGROUND: The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28713509/mechanical-ventilation-practice-in-egyptian-pediatric-intensive-care-units
#3
Bassant Salah Meligy, Sally Kamal, Seham Awad El Sherbini
INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28705247/detecting-impaired-myocardial-relaxation-in-sepsis-with-a-novel-tissue-doppler-parameter-septal-e-s
#4
David J Clancy, Michel Slama, Stephen Huang, Timothy Scully, Anthony S McLean, Sam R Orde
BACKGROUND: Left ventricular diastolic dysfunction is associated with mortality outcomes in severe sepsis and septic shock. There are ongoing issues with diagnosing diastolic dysfunction in this cohort, partly owing to the poor applicability of traditional parameters in the hyperdynamic circulation. In this feasibility study, we sought to assess the utility of a novel parameter (septal e'/s') to identify diastolic dysfunction in patients with severe sepsis and septic shock who had normal systolic function against the 2016 American Society Echocardiography and European Association of Cardiovascular Imaging (ASE/EACI) guidelines on diastolic dysfunction...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28704502/brain-natriuretic-peptide-bnp-may-play-a-major-role-in-risk-stratification-based-on-cerebral-oxygen-saturation-by-near-infrared-spectroscopy-in-patients-undergoing-major-cardiovascular-surgery
#5
Hiroshi Mukaida, Masakazu Hayashida, Satoshi Matsushita, Makiko Yamamoto, Atsushi Nakamura, Atsushi Amano
PURPOSE: A previous study reported that low baseline cerebral oxygen saturation (ScO2) (≤50%) measured with near-infrared spectroscopy was predictive of poor clinical outcomes after cardiac surgery. However, such findings have not been reconfirmed by others. We conducted the current study to evaluate whether the previous findings would be reproducible, and to explore mechanisms underlying the ScO2-based outcome prediction. METHODS: We retrospectively investigated 573 consecutive patients, aged 20 to 91 (mean ± standard deviation, 67...
2017: PloS One
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#6
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28699492/adverse-drug-reactions-in-critical-care-setting-a-systematic-review
#7
Joshua Lisha, Velu Annalakshmi, Jose Maria, Devi Padmini
BACKGROUND: The prevalence of adverse drug reactions (ADRs) is reported to be high in critical care units. We conducted a systematic review to study the prevalence, drugs implicated, preventability, predictability, severity and determinants of ADRs in critical care settings. METHODS: We searched MEDLINE, EMBASE, PROQUEST and OVID (January 1995 to June 2015) using pre-specified appropriate medical subject heading (MeSH) terms. Of 1552 studies, 34 studies were included for data extraction and synthesis...
July 10, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28691497/increased-mortality-risk-in-diabetic-patients-discharged-from-hospital-with-insulin-therapy-after-an-acute-myocardial-infarction-data-from-the-fast-mi-2005-registry
#8
Vincent Bataille, Jean Ferrières, Nicolas Danchin, Etienne Puymirat, Marianne Zeller, Tabassome Simon, Didier Carrié
BACKGROUND: Merits of insulin use for diabetes treatment in patients with advanced atherosclerosis are debated. This observational study conducted in diabetic patients after an acute myocardial infarction aimed to assess whether insulin prescription at discharge (IPD) was related to all-cause mortality during follow-up. METHODS: Subjects were diabetic patients admitted in intensive- or coronary-care units for acute myocardial infarction (consecutively recruited in 223 centres in France) and discharged alive from the hospital, with or without an IPD...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28672079/acute-kidney-injury-in-congenital-cardiac-surgery-comparison-of-prifle-akin
#9
Murat Tanyildiz, Mesiha Ekim, Tanil Kendirli, Ercan Tutar, Zeynep Eyileten, Zeynep Birsin Ozcakar, Asli Kavaz, Fatos Yalcınkaya, Adnan Uysalel, Semra Atalay
BACKGROUND: Acute kidney injury (AKI) is associated with an increased risk of mortality especially in pediatric intensive care units. The aim of this study is to determine the risk factors of AKI in children undergoing cardiac surgery for congenital heart disease and compare two different classification systems: pRIFLE and AKIN. METHODS: We retrospectively analyzed 145 patient undergoing pediatric congenital heart surgery who were between 1 month and 18 years and treated by the cardiovascular surgery department from January 2009 to October 2011...
July 3, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28662606/patients-with-vasculitides-admitted-to-the-intensive-care-unit-implications-from-a-single-center-retrospective-study
#10
Yael Haviv, Ora Shovman, Nicola Luigi Bragazzi, Kassem Sharif, Yarden Yavne, Yehuda Shoenfeld, Howard Amital, Abdulla Watad
BACKGROUND: Vasculitides are a group of disorders characterized by inflammation of vessels. Vasculitides may have life-threatening complications with significant morbidity and mortality; however, information regarding the outcome and prognosis of patients with vasculitides requiring intensive care unit (ICU) is scarce. METHODS: Data of patients with vasculitides admitted to the ICU of the Sheba Medical Center between the years 2000 and 2014 were retrieved retrospectively...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28662238/use-of-audiometric-measurement-for-assessment-of-vocal-fold-function-in-postextubation-infants
#11
Yi-Chun Carol Liu, Indu Varier, Julina Ongkasuwan
Importance: Infants with vocal-fold motion impairment (VFMI) have an increased risk of aspiration and pulmonary complications. Flexible nasolaryngoscopy (FNL) is the gold standard for evaluation of vocal-fold mobility. Although safe, FNL causes measurable physiologic changes. Noxious stimuli, especially in neonates in the cardiovascular intensive care unit, may cause imbalance between the pulmonary and systemic circulations and potentially circulatory collapse. Objective: To examine whether bedside measurement of infant cry volume using a smartphone application can be a screening tool for vocal-fold movement in FNL...
June 29, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28643996/age-related-outcome-of-patients-after-traumatic-brain-injury-a-single-centre-observation
#12
Rolf Erlebach, Alberto Pagnamenta, Stephanie Klinzing, Federica Stretti, Silvia Cottini, Reto Schüpbach, Peter Steiger, Giovanna Brandi
BACKGROUND: Study-purpose is to analyze clinical features of patients with traumatic brain injury (TBI), their age-related outcomes and determinants of long- term outcome. METHODS: This retrospective cohort study was conducted in a level I University Swiss trauma center. Consecutive patients with moderate to severe TBI admitted for more than 48 hours to the Intensive Care Unit were included. Patients' and trauma characteristics, management during ICU-stay, prognostic scores and long- term outcomes were analyzed...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28641581/thyrotoxic-and-pheochromocytoma-multisystem-crisis-a-case-report
#13
Kodai Suzuki, Takahito Miyake, Hideshi Okada, Fuminori Yamaji, Yuichiro Kitagawa, Tetsuya Fukuta, Ryu Yasuda, Yoshihito Tanaka, Haruka Okamoto, Sho Nachi, Tomoaki Doi, Takahiro Yoshida, Keisuke Kumada, Shozo Yoshida, Hiroaki Ushikoshi, Izumi Toyoda, Shinji Ogura
BACKGROUND: Thyrotoxic crisis and pheochromocytoma multisystem crisis are rare, life-threatening, emergency endocrine diseases with various clinical manifestations. Here we report a case of a patient who simultaneously developed thyrotoxic crisis and pheochromocytoma multisystem crisis and required intensive cardiovascular management. CASE PRESENTATION: A 60-year-old Asian man experienced nausea and vomiting, and subsequently developed dyspnea and cold sweats while farming...
June 23, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28625241/-efficacy-and-safety-of-intravenous-recombinant-human-brain-natriuretic-peptide-in-patients-with-severe-heart-failure-a-prospective-multicenter-clinical-study
#14
Xue Feng, Yue Wu, Ying Meng, Yizhen Wei
OBJECTIVE: To explore the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the patients with severe heart failure (HF). METHODS: A prospective multicenter study was conducted. Patients whose age > 18 years old, and with the New York Heart Association (NYHA) cardiac function grade over III-IV, acute cardiac insufficiency and the acute exacerbation of chronic cardiac insufficiency admitted to intensive care unit/cardiovascular care unit (ICU/CCU) of 58 Hospitals in China were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#15
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28603411/effect-of-small-dose-levosimendan-on-mortality-rates-and-organ-functions-in-chinese-elderly-patients-with-sepsis
#16
Xin Wang, Shikui Li
AIM: As a primary cause of death not only in Western countries but also in the People's Republic of China, sepsis is diagnosed as abnormal organ functions as a result of a disordered response to a severe infection. This study was designed to assess the effect of small-dose levosimendan without a loading dose on mortality rates and organ functions in Chinese elderly patients with sepsis. METHODS: Following a prospective, randomized, and double-blinded design, 240 Chinese elderly patients with sepsis shock were admitted to the intensive care unit (ICU)...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28598043/clinical-profile-of-hypertensive-emergencies-in-an-intensive-care-unit
#17
Shubhangi V Dhadke, Vithal N Dhadke, Dhruv S Batra
AIMS AND OBJECTIVE: To study the prevalence of hypertensive emergencies in an ICU set up and to study the clinical presentation of hypertensive emergencies related to cardiovascular, neurological and renovascular system. METHODS: Type of Study: Cross-sectional, descriptive study. DURATION OF STUDY: Two years from 1st December 2011 till 30th November 2013. SAMPLE SIZE: 50 patients of hypertensive emergencies admitted to the intensive care unit of Dr...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28592014/-clinical-characteristics-of-new-onset-organ-dysfunction-in-pediatric-intensive-care-unit
#18
Y H Yang, L Pei, N Yang, G F Wen, W Xu, C F Liu
Objective: To investigate the incidence and clinical characteristics of new-onset organ dysfunction of patients in pediatric intensive care unit (PICU). Method: A retrospective observational study identified all patients admitted to the PICU of Shengjing Hospital Affiliated to China Medical University from January 2015 to January 2016. The functional status score (FSS) was evaluated at admission and hospital discharge respectively, and the difference defined as ΔFSS between the FSS at hospital discharge and the FSS at admission was calculated...
June 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28589535/low-hdl-levels-in-sepsis-versus-trauma-patients-in-intensive-care-unit
#19
Sébastien Tanaka, Julien Labreuche, Elodie Drumez, Anatole Harrois, Sophie Hamada, Bernard Vigué, David Couret, Jacques Duranteau, Olivier Meilhac
BACKGROUND: The protective cardiovascular effect of high-density lipoproteins (HDLs) is considered to chiefly rely on reverse cholesterol transport from peripheral tissues back to the liver. However, HDL particles display pleiotropic properties, including anti-inflammatory, anti-apoptotic or antioxidant functions. Some studies suggest that HDL concentration decreases during sepsis, and an association was reported between low HDL levels and a poor outcome. Like sepsis, trauma is also associated with a systemic inflammatory response syndrome...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28586614/frequency-indications-and-complications-of-pulmonary-artery-catheter-insertion-in-adult-open-heart-surgery-patients-of-a-tertiary-care-hospital
#20
Syed Shabbir Ahmed, Mohammad Irfan Akhtar, Rehana Kamal
BACKGROUND: Patients presenting for cardiac surgery have unstable cardiovascular disease and haemodynamics with multiple coexisting diseases. Optimal monitoring in the perioperative period is very important for best perioperative outcome. The introduction of the flow-directed pulmonary artery catheter (PAC) into clinical practice is one of the most important and popular advances in the field of cardiac anaesthesia. The objective of the study was to determine the frequency, indications and complications of pulmonary artery catheter insertion in adult open-heart surgery patients...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
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