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Acute cardiac care

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https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#1
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29676943/impact-of-preoperative-thrombocytopenia-on-the-outcome-after-coronary-artery-bypass-grafting
#2
Wail Nammas, Magnus Dalén, Stefano Rosato, Riccardo Gherli, Daniel Reichart, Giuseppe Gatti, Francesco Onorati, Giuseppe Faggian, Marisa De Feo, Ciro Bancone, Sidney Chocron, Sorosh Khodabandeh, Giuseppe Santarpino, Antonino S Rubino, Daniele Maselli, Saverio Nardella, Antonio Salsano, Tiziano Gherli, Francesco Nicolini, Marco Zanobini, Matteo Saccocci, Karl Bounader, Paola D'Errigo, Tuomas Kiviniemi, Eeva-Maija Kinnunen, Andrea Perrotti, Juhani Airaksinen, Giovanni Mariscalco, Vito G Ruggieri, Fausto Biancari
The impact of thrombocytopenia on postoperative bleeding and other major adverse events after cardiac surgery is unclear. This issue was investigated in a series of patients who underwent isolated coronary artery bypass grafting (CABG) from the prospective, multicenter E-CABG registry. Preoperative thrombocytopenia was defined as preoperative platelet count <150 × 109 /L and it was considered moderate-severe when preoperative platelet count was <100 × 109 /L. Multilevel mixed-effects regression analysis was performed to adjust the effect of thrombocytopenia on outcomes for baseline and operative covariates as well as for interinstitutional differences in patient-blood management...
April 20, 2018: Platelets
https://www.readbyqxmd.com/read/29675278/adrenocorticotropic-hormone-secreting-pheochromocytoma-underlying-glucocorticoid-induced-pheochromocytoma-crisis
#3
Gil A Geva, David J Gross, Haggi Mazeh, Karine Atlan, Iddo Z Ben-Dov, Matan Fischer
Context: Pheochromocytomas are hormone secreting tumors of the medulla of the adrenal glands found in 0.1-0.5% of patients with hypertension. The vast majority of pheochromocytomas secrete catecholamines, but they have been occasionally shown to also secrete interleukins, calcitonin, testosterone, and in rare cases adrenocorticotropic hormone. Pheochromocytoma crisis is a life threatening event in which high levels of catecholamines cause a systemic reaction leading to organ failure. Case Description: A 70-year-old man was admitted with acute myocardial ischemia following glucocorticoid administration as part of an endocrine workup for an adrenal mass...
2018: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/29672991/glycaemic-optimization-for-patients-with-cardiac-disease-a-before-and-after-study
#4
Tripti Joshi, Sarah-Jane Pullen, Alison Gebuehr, Christopher Oldmeadow, John Richard Attia, Shamasunder Halady Acharya
AIM: To investigate if glycaemic profiles and outcomes of patients with diabetes admitted for cardiothoracic surgery or acute coronary syndrome improved after implementation of a structured glycaemia management guideline. METHODS: This is a retrospective before-and-after comparative analysis of outcomes for all consecutive cardiothoracic and acute coronary syndrome patients with diabetes (N = 375), who were admitted at our tertiary-care university-affiliated hospital during the preguideline period (July-December, 2013) and the postguideline period (July-December, 2014)...
April 19, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29672418/perioperative-use-of-levosimendan-improves-clinical-outcomes-in-patients-post-cardiac-surgery-a-systematic-review-and-meta-analysis
#5
Hua Qiang, Xiu Luo, Jian-Hua Huo, Zhi-Quan Wang
Severe postoperative complications can affect cardiac surgery patients. Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery. However, the patient benefits are controversial. PubMed, Embase, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) comparing levosimendan with control in adult cardiac surgery patients. Twenty-five studies (3247 patients) were included. Pooled data indicated that levosimendan reduced mortality after cardiac surgery (OR 0...
April 3, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29670472/seasonal-incidence-of-acute-coronary-syndrome-and-its-features
#6
Enisa Hodzic, Semir Perla, Amer Iglica, Marina Vucijak
Introduction: Acute coronary syndrome (ACS) is one of the most common health problems in the world and the leading cause of death. Goal: The goals of this study are to determine: ACS type, risk factors, incidence and the seasonal distribution of occurrence Spring/Summer, Autumn/Winter, ACS incidence by age and gender, and complications (post-infarction angina and heart failure) and fatal outcomes of ACS per season. Material and methodology: This study is designed as retrospective-prospective and analytical, which included 250 patients hospitalized in the Intensive Cardiac care unit of the Clinic for heart disease, blood vessels and rheumatism in the period from June 2013 to July 2014...
March 2018: Materia Socio-medica
https://www.readbyqxmd.com/read/29666787/cardiac-output-monitoring-in-preterm-infants
#7
REVIEW
Matthew McGovern, Jan Miletin
Maintaining optimal circulatory status is a key component of preterm neonatal care. Low-cardiac output (CO) in the preterm neonate leads to inadequate perfusion of vital organs and has been linked to a variety of adverse outcomes with heightened acute morbidity and mortality and adverse neurodevelopmental outcomes. Having technology available to monitor CO allows us to detect low-output states and potentially intervene to mitigate the unwanted effects of reduced organ perfusion. There are many technologies available for the monitoring of CO in the preterm neonatal population and while many act as useful adjuncts to aid clinical decision-making no technique is perfect...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29664001/-protective-effect-of-mild-hypothermia-at-different-starting-times-on-organ-function-in-patient-with-exertional-heat-stroke
#8
Qinghua Li, Rongqing Sun, Hongdi Lyu, Dexin Shen, Qing Hu, Haiwei Wang, Nannan Wang, Jin Yan, Jing Wang
OBJECTIVE: To investigate the protective effect of mild hypothermia at different starting times on the physiological functions of the viscera of exertional heat stroke (EHS). METHODS: A prospective randomized controlled trial was conducted. EHS patients admitted to intensive care unit of the 159th Hospital of People's Liberation Army and the First Affiliated Hospital of Zhengzhou University from June 2015 to June 2017 were enrolled. The patients were divided into 2, 4, 6 hours start hypothermia treatment groups according to the random number table method, the mild hypothermia was initiated at 2, 4 and 6 hours after the disease onset respectively, and the methods were the same in each group...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29663994/-predictive-value-of-early-phrase-echocardiography-and-cardiac-biological-markers-in-patients-with-severe-sepsis-a-five-year-single-center-retrospective-study
#9
Xuefeng Zang, Wei Chen, Bo Sheng, Lei Zhao, Xuyun Gu, Jie Zhen, Ping Liu
OBJECTIVE: To assess the predictive value of early phrase echocardiography and cardiac biomarkers in patients with severe sepsis. METHODS: A retrospective analysis of severe septic patients (patients with acute coronary syndrome and end stage renal disease were excluded) in department of intensive care unit of Capital Medical University Affiliated Beijing Shijitan Hospital from January 2013 to December 2017 was conducted. The acute physiology and chronic health evaluation II (APACHE II) score, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), myoglobin (MYO), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB) within 6 hours after admission, and bedside echocardiography indexes [left ventricular ejection fraction (LVEF), the ratio of the peak blood flow velocity in the early stage of the mitral valve and the peak blood flow rate of the mitral valve (E/A ratio)] within 6 hours after diagnosis were recorded...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29661625/unusual-presentation-of-middle-east-respiratory-syndrome-coronavirus-leading-to-a-large-outbreak-in-riyadh-during-2017
#10
Hala Amer, Abdulrahman S Alqahtani, Hind Alzoman, Nawfal Aljerian, Ziad A Memish
BACKGROUND: The hallmark of Middle East respiratory syndrome coronavirus (MERS-CoV) disease is the ability to cause major health care-associated nosocomial outbreaks with superspreading events leading to massive numbers of cases and excessive morbidity and mortality. In this report, we describe a patient who presented with acute renal failure requiring hemodialysis and became a MERS-CoV superspreader, igniting a recent multihospital outbreak in Riyadh. MATERIAL AND RESULTS: Between May 31 and June 15, 2017, 44 cases of MERS-CoV infection were reported from 3 simultaneous clusters from 3 health care facilities in Riyadh, Saudi Arabia, including 11 fatal cases...
April 13, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29660009/critical-care-in-the-military-health-system-a-24-h-point-prevalence-study
#11
Raymond Fisher, Christopher J Colombo, Cristin A Mount, Elizabeth A Mann-Salinas, Adam W Bostick, Konrad Davis, James K Aden, Kevin K Chung, Mary S McCarthy, Jeremy C Pamplin
Background: Healthcare expenditures are a significant economic cost with critical care services constituting one of its largest components. The Military Health System (MHS) is the largest, global healthcare system of its kind. In this project, we sought to describe critical care services and the patients who receive them in the MHS. Methods: We surveyed 26 military treatment facilities (MTFs) representing 38 critical care services or intensive care units (ICUs)...
April 11, 2018: Military Medicine
https://www.readbyqxmd.com/read/29657734/treatment-of-a-patient-with-acute-aortic-dissection-using-extracorporeal-cardiopulmonary-resuscitation-after-an-out-of-hospital-cardiac-arrest-a-case-report
#12
Takahiro Yukawa, Kazuhiro Sugiyama, Kazuki Miyazaki, Takahiro Tanabe, Susumu Ishikawa, Yuichi Hamabe
Case: Circulatory support using veno-arterial extracorporeal membrane oxygenation for aortic disease is conventionally contraindicated. In this case, a 66-year-old man experienced cardiopulmonary arrest caused by acute aortic dissection. When exercising in the gym, he experienced chest discomfort, so the staff immediately called an ambulance. While in the ambulance, he experienced cardiopulmonary arrest. His initial electrocardiogram showed ventricular fibrillation. At the emergency department, we immediately performed extracorporeal cardiopulmonary resuscitation...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29655827/30-day-episode-payments-and-heart-failure-outcomes-among-medicare-beneficiaries
#13
Rishi K Wadhera, Karen E Joynt Maddox, Yun Wang, Changyu Shen, Robert W Yeh
OBJECTIVES: The purpose of this study was to examine the association of 30-day payments for an episode of heart failure (HF) care at the hospital level with patient outcomes. BACKGROUND: There is increased focus among policymakers on improving value for HF care, given its rising prevalence and associated financial burden in the United States; however, little is known about the relationship between payments and mortality for a 30-day episode of HF care. METHODS: Using Medicare claims data for all fee-for-service beneficiaries hospitalized for HF between July 1, 2011, and June 30, 2014, we examined the association between 30-day Medicare payments at the hospital level (beginning with a hospital admission for HF and across multiple settings following discharge) and patient 30-day mortality using mixed-effect logistic regression models...
April 5, 2018: JACC. Heart Failure
https://www.readbyqxmd.com/read/29652271/prophylactic-preoperative-levosimendan-for-off-pump-coronary-artery-bypass-grafting-in-patients-with-left-ventricular-dysfunction-single-centered-randomized-prospective-study
#14
Pushkar Mahendra Desai, Manjula S Sarkar, Sanjeeta R Umbarkar
Background: Off-pump coronary artery bypass surgery (OPCAB) is often complicated by hemodynamic instability, especially in patients with prior left ventricular (LV) dysfunction and appropriate choice of inotrope plays a vital role in perioperative management of these patients. Aim and Objective: To study hemodynamic effects and immediate outcome of prophylactic infusion of levosimendan in patients with the LV dysfunction undergoing OPCAB surgery and whether this strategy helps in successful conduct of OPCAB surgery...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29651826/new-percutaneous-interventions-in-heart-failure
#15
Elisabetta Moscarella, Salvatore Brugaletta, Manel Sabaté
Chronic heart failure (HF) is one of the main causes of mortality and morbidity worldwide and represents a growing challenge in interventional cardiology. Its prevalence is recently increasing due to the improvements in cardiac care with subsequent significant reduction in the HF acute mortality. HF may occur with either a reduced left ventricular ejection fraction (LVEF) (LVEF<40%, HFrEF) or a preserved EF (typically LVEF≥50%, HFpEF) indicative of diastolic dysfunction. Despite recent advances in drug therapies as well as in nonpharmacological strategies, including defibrillators, cardiac resynchronization therapy, LV assist devices (LVAD), mortality in HF remains high...
April 12, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29650397/assessment-of-five-different-probes-for-lung-ultrasound-in-critically-ill-patients-a-pilot-study
#16
Xavier Bobbia, Margaux Chabannon, Thierry Chevallier, Jean Emmanuel de La Coussaye, Jean Yves Lefrant, Sarah Pujol, Pierre-Géraud Claret, Laurent Zieleskiewicz, Claire Roger, Laurent Muller
INTRODUCTION: The present study was aimed at comparing the diagnosis concordance of five echo probes of lung ultrasound (LUS) with CT scans in intensive care and emergency patients with acute respiratory failure. MATERIALS: This prospective, observational, pilot study involved 10 acute patients in whom a thoracic CT scan was performed. An expert performed an LUS reference exam using five different probes: three probes with a high-quality conventional echo machine (cardiac phased-array probe, abdominal convex probe, linear probe) and two probes (cardiac and linear) with a pocket ultrasound device (PUD)...
April 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29642928/diagnostic-and-management-of-life-threatening-adult-onset-still-disease-a-french-nationwide-multicenter-study-and-systematic-literature-review
#17
Antoine Néel, Anaïs Wahbi, Benoit Tessoulin, Julien Boileau, Dorothée Carpentier, Olivier Decaux, Laurence Fardet, Guillaume Geri, Pascal Godmer, Cécile Goujard, Hervé Maisonneuve, Arnaud Mari, Jacques Pouchot, Jean-Marc Ziza, Cédric Bretonnière, Mohamed Hamidou
BACKGROUND: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disorder. A few patients develop organ complications that can be life-threatening. Our objectives were to describe the disease course and phenotype of life-threatening AOSD, including response to therapy and long-term outcome. METHODS: A multicenter case series of intensive care medicine (ICU) patients with life-threatening AOSD and a systematic literature review. RESULTS: Twenty patients were included...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29642728/tunnelling-a-midline-catheter-when-the-traffic-light-shifts-from-yellow-to-green
#18
Adam Fabiani, Lorella Dreas, Gianfranco Sanson
INTRODUCTION: A safe, largely used practice for difficult venous access patients is positioning a catheter in deeper veins under ultrasound guide. However, the risk of complications is increased when there is a high catheter-to-vein ratio or when the insertion site is in a zone with particular anatomical/physiological characteristics. CASE DESCRIPTION: A 60-year-old woman admitted to a post-operative intensive care unit after cardiac surgery had a complicated post-operative course...
April 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#19
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29629931/magnetic-resonance-imaging-in-neurocritically-ill-patients-who-fails-and-how
#20
Joong-Goo Kim, Myung-Ah Ko, Han-Bin Lee, Sang-Beom Jeon
OBJECTIVES: Performing magnetic resonance imaging (MRI) in neurocritically ill patients is challenging because it often requires sedation and withholding care in the neurological intensive care unit. This study investigated the incidence of and reasons for failed or complicated MRI (MRI-FC) in such patients. METHODS: A consecutive series of 218 neurocritically ill patients who underwent brain MRI were retrospectively evaluated. Failed or complicated MRI included failure to obtain all ordered sequences, unscheduled sedative administration, decrease in oxygen saturation to less than 90%, hypotension (≥40-mm Hg decrease and/or use of inotropic agents), and cardiac or respiratory arrest...
April 6, 2018: Journal of Patient Safety
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