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Intubation myocardial infarction

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https://www.readbyqxmd.com/read/28011279/association-of-prophylactic-endotracheal-intubation-in-critically-ill-patients-with-upper-gi-bleeding-and-cardiopulmonary-unplanned-events
#1
Umar Hayat, Peter J Lee, Hamid Ullah, Shashank Sarvepalli, Rocio Lopez, John J Vargo
BACKGROUND: Prophylactic endotracheal intubation (PEI) is often advocated to mitigate the risk of cardiopulmonary adverse events in patients presenting with brisk upper gastrointestinal bleed (UGIB). However, the benefit of such a measure remains controversial. Our study aimed to compare the incidence of cardiopulmonary unplanned events (CUE) between patients who underwent endotracheal intubation versus those who didn't, in critically ill patients with brisk UGIB. METHODS: Patients aged 18 years or older who had presented at Cleveland Clinic between 2011 and 2014 with hematemesis and/or patients with melena with consequential hypovolemic shock were included...
December 20, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27976497/prospective-and-explicit-clinical-validation-of-the-ottawa-heart-failure-risk-scale-with-and-without-use-of-quantitative-nt-probnp
#2
Ian G Stiell, Jeffrey J Perry, Catherine M Clement, Robert J Brison, Brian H Rowe, Shawn D Aaron, Andrew McRae, Bjug Borgundvaag, Lisa A Calder, Alan J Forster, George A Wells
OBJECTIVES: We previously developed the Ottawa Heart Failure Risk Scale (OHFRS) to assist with disposition decisions for acute heart failure patients in the emergency department (ED). We sought to prospectively evaluate the accuracy, acceptability, and potential impact of OHFRS. METHODS: This prospective observational cohort study was conducted at six tertiary hospital EDs. Patients with acute heart failure were evaluated by ED physicians for the 10 OHFRS criteria and then followed for 30 days...
December 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27924176/our-clinical-experience-of-self-expanding-metal-stent-for-malignant-central-airway-obstruction
#3
Akash Verma, Chee Kiang Phua, Qiu Mei Wu, Wen Yuan Sim, Audrey Wee Chuan Rui, Soon Keng Goh, Benjamin Ho, Ai Ching Kor, Andrew S Y Wong, Albert Y H Lim, Dessmon Y H Tai, John Abisheganaden
BACKGROUND: We studied the safety, effectiveness, and limitations of airway stenting using self-expanding metal stent (SEMS) in patients with malignant central airway obstruction (CAO). METHODS: A retrospective review of records of patients undergoing SEMS placement for malignant CAO during year 2013 - 2014 was done. RESULTS: Sixteen patients (11 males and five females) underwent SEMS placement for malignant CAO. Median (range) age was 66 (54 - 78) years...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27899140/transapical-transcatheter-aortic-valve-replacement-in-patients-with-or-without-prior-coronary-artery-bypass-graft-operation
#4
Konstantinos V Voudris, S Chiu Wong, Ryan Kaple, Polydoros N Kampaktsis, Andreas R de Biasi, Jonathan S Weiss, Richard Devereux, Karl Krieger, Luke Kim, Rajesh V Swaminathan, Dmitriy N Feldman, Harsimran Singh, Nikolaos J Skubas, Robert M Minutello, Geoffrey Bergman, Arash Salemi
BACKGROUND: Transapical approach (TA) is an established access alternative to the transfemoral technique in patients undergoing transcatheter aortic valve replacement (TAVR) for treatment of symptomatic aortic valve stenosis. The impact of prior coronary artery bypass grafting (CABG) on clinical outcomes in patients undergoing TA-TAVR is not well defined. METHODS: A single center retrospective cohort analysis of 126 patients (male 41%, mean age 85.8 ± 6.1 years) who underwent TA balloon expandable TAVR (Edwards SAPIEN, SAPIEN XT or SAPIEN 3) was performed...
November 29, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27832626/ischemic-postconditioning-regulated-mir-499-protects-the-rat-heart-against-ischemia-reperfusion-injury-by-inhibiting-apoptosis-through-pdcd4
#5
Jianbing Zhu, Kang Yao, Qian Wang, Junjie Guo, Hongtao Shi, Leilei Ma, Haibo Liu, Wei Gao, Yunzeng Zou, Junbo Ge
BACKGROUND: Here, we determined miR-499 involvement in the protective effect of ischemic postconditioning (IPC) against myocardial ischemia/reperfusion (I/R) injury and identified the underlying mechanisms. METHODS: To investigate the cardioprotective effect of IPC-induced miR-499, rats were divided into the following five groups: sham, I/R, IPC, IPC + scramble, and IPC + antagomiR-499. Hemodynamic indexes were measured by carotid-artery intubation to assess left ventricular function ...
2016: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/27769659/multiple-postoperative-complications-making-sense-of-the-trajectories
#6
Shara I Feld, Sarah E Tevis, Alexander G Cobian, Mark W Craven, Gregory D Kennedy
BACKGROUND: Many studies have evaluated predictors of postoperative complications, yet little is known about the development of multiple complications. The goal of this study was to assess complication timing in cascades of multiple complications and the risk of future complications given a patient's first complication. METHODS: This study includes 30-day, postoperative complications from the American College of Surgeons National Surgical Quality Improvement Program for all patients who underwent major inpatient and outpatient operative procedures from 2005-2013...
December 2016: Surgery
https://www.readbyqxmd.com/read/27760636/-safety-and-efficacy-of-off-pump-coronary-artery-bypass-grafting-in-octogenarians
#7
T S Liu, B T Chen, R Dong, Y Li, Y Zhao, K Hua
Objective: To discuss the clinical safety and efficacy about off-pump coronary artery bypass grafting (OPCABG) in octogenarians. Methods: From June 2005 to July 2014, 252 patients (male 208, female 44, with a mean age of 81.7 years old) underwent OPCABG in Beijing Anzhen Hospital who were aged 80 years or older were enrolled. Results: Eight (3.2%) patients were diagnosed as single vessel coronary artery disease (CAD), 29 cases (11.5%) were diagnosed as bifurcation vessel CAD, and 215 cases (85.3%) were multivessel CAD...
September 27, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27590209/characteristics-and-outcomes-for-acute-heart-failure-in-elderly-patients-presenting-to-the-ed
#8
Pierre-Géraud Claret, Ian G Stiell, Justin W Yan, Catherine M Clement, Brian H Rowe, Lisa A Calder, Jeffrey J Perry
INTRODUCTION: The first aim of this study was to investigate the characteristics for elderly patients with acute heart failure presenting to the emergency department (ED). The second aim was to determine the characteristics of these elderly patients associated with serious adverse events. METHODS: The population was divided into 2 age groups, <80 and ≥80 years. The primary outcome was the occurrence of a serious adverse event, defined as either death from any cause within 30 days of the index ED visit or any of the following events within 14 days of the index ED visit: admission to a monitored unit, intubation, need for noninvasive ventilation, myocardial infarction, major procedure, or, for patients who were discharged after the initial visit, return to the ED resulting in admission to hospital...
August 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27499694/predictive-value-of-echocardiographic-abnormalities-and-the-impact-of-diastolic-dysfunction-on-in-hospital-major-cardiovascular-complications-after-living-donor-kidney-transplantation
#9
Eun Jung Kim, Suyon Chang, So Yeon Kim, Kyu Ha Huh, Soojeong Kang, Yong Seon Choi
Patients with end-stage renal disease (ESRD) show characteristic abnormalities in cardiac structure and function. We evaluated the influence of these abnormalities on adverse cardiopulmonary outcomes after living donor kidney transplantation in patients with valid preoperative transthoracic echocardiographic evaluation. We then observed any development of major postoperative cardiovascular complications and pulmonary edema until hospital discharge. In-hospital major cardiovascular complications were defined as acute myocardial infarction, ventricular fibrillation/tachycardia, cardiogenic shock, newly-onset atrial fibrillation, clinical pulmonary edema requiring endotracheal intubation or dialysis...
2016: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/27393759/intra-aortic-balloon-pump-dependent-patient-transports-by-critical-care-paramedics
#10
Russell D MacDonald, Felipe Allendes
OBJECTIVE: Transport of intra-aortic balloon pump (IABP)-dependent patients between hospitals is increasingly common. The transports are typically time-sensitive and require personnel familiar with IABP operation and management of a potentially unstable patient. This study examined transports performed by specially trained critical care paramedics in a large air medical and land critical care transport service. METHODS: This retrospective, descriptive review prospectively collected data for IABP-dependent patient transports in Ontario, Canada in a 10-year interval beginning September 2003...
July 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27312076/ivabradine-in-patients-with-st-elevation-myocardial-infarction-complicated-by-cardiogenic-shock-a-preliminary-randomized-prospective-study
#11
RANDOMIZED CONTROLLED TRIAL
Francesco Barillà, Giuseppe Pannarale, Concetta Torromeo, Vincenzo Paravati, Maria Cristina Acconcia, Gaetano Tanzilli, Enrico Mangieri, Tania Dominici, Francesco Martino, Gaetano Pannitteri, Carlo Gaudio
BACKGROUND AND OBJECTIVE: An elevated heart rate (HR) is an independent risk factor for mortality and morbidity in patients with acute heart failure (HF). The purpose of this study was to evaluate the impact of ivabradine, a selective HR-lowering agent, in patients with cardiogenic shock (CS) complicating ST-elevation acute myocardial infarction (AMI). METHODS: Patients with post-AMI CS were randomized to standard treatment (SDT, 28 patients) or to standard treatment plus ivabradine (I + SDT, 30 patients)...
October 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27279128/prognostic-implications-of-fluid-balance-in-st-elevation-myocardial-infarction-complicated-by-cardiogenic-shock
#12
Yaron Arbel, Ronen Mass, Tomer Ziv-Baran, Shafik Khoury, Gilad Margolis, Ben Sadeh, Nir Flint, Jeremy Ben-Shoshan, Talya Finn, Gad Keren, Yacov Shacham
BACKGROUND: Positive fluid balance has been associated with adverse outcomes in patients admitted to general intensive care units. We analysed the relationship between a positive fluid balance and its persistence over time in terms of in-hospital outcomes among ST elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock. METHODS: We retrospectively studied fluid intake and output for 96 hours following hospital admission in 48 consecutive adult patients with STEMI complicated by cardiogenic shock, all undergoing primary angioplasty...
June 8, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/27274373/experience-of-hemostasis-in-tracheal-bleeding-very-close-to-the-carina-by-the-bronchial-blocker-a-case-report
#13
MinKi Son, Sangjun Lee, Sang Hyun Lee, Taewan Lim, Soo Kyung Lee, Kook Hyun Lee
Massive hemoptysis is respiratory compromise which should be managed as a life-threatening condition. In our case, the bronchial blocker played a role in hemostasis of tracheal bleeding very close to the carina and prevented further spillage into the contralateral lung. Right-sided one-lung isolation in an 87-year-old female, who received cardiopulmonary resuscitation due to myocardial infarction, was requested due to hemoptysis. Right-sided bronchial bleeding was suspected on auscultation, but esophageal and tracheal bleeding due to violent intubation with a stylet was also considered...
June 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27206565/gabapentin-for-the-hemodynamic-response-to-intubation-systematic-review-and-meta-analysis
#14
Brett Doleman, Matthew Sherwin, Jonathan N Lund, John P Williams
PURPOSE: Endotracheal intubation is the gold standard for securing the airway before surgery. Nevertheless, this procedure can produce an activation of the sympathetic nervous system and result in a hemodynamic response which, in high-risk patients, may lead to cardiovascular instability and myocardial ischemia. The aim of this review was to evaluate whether gabapentin can attenuate this response and whether such an attenuation could translate into reduced myocardial ischemia and mortality...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27193372/a-case-of-survival-myocardial-infarction-and-ventricular-arrhythmia-induced-by-severe-hydrogen-sulfide-poisoning
#15
Jie Chen, Shenjie Chen, Wei Mao
Most cases of acute hydrogen sulfide (H2S) poisoning in China are caused by sewage processing. With the rapid development of urbanization in China, H2S poisoning is showing an increasing trend. Here, we report a case of survival from severe H2S poisoning. A 40-year-old worker was found in the underground sewer lines. He was unresponsive with bilaterally dilated pupils and had poor oxygen saturation. After intubation, he was transferred to the intensive care unit. He developed respiratory failure, acute myocardial infarction, ventricular arrhythmia and left ventricular function impairment, requiring artificial ventilation with highly concentrated oxygen, hyperbaric oxygen treatment and drug therapy...
2016: Cardiology
https://www.readbyqxmd.com/read/27139292/methemoglobinemia-secondary-to-topical-benzocaine-application-to-gastrostomy-site
#16
Matthew Lipton, Sarah M Szlam, Kim Barker, John G Benitez
Benzocaine is a common topical anesthetic that has the ability to induce methemoglobinemia (MetHgb) in large doses. We describe a 4-year-old girl who received a standard dose of topical benzocaine to her gastrostomy mucosa that resulted in rapid, severe MetHgb. She required intubation, mechanical ventilation, and multiple doses of methylene blue for treatment. The resultant tissue hypoxia from MetHgb caused profound confusion, cyanosis, and myocardial infarction. Although the patient did not sustain any permanent disability, this case demonstrates the need for emergency providers to rapidly identify and treat MetHgb to reverse tissue hypoxia and prevent long-term sequelae...
May 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27102502/ventricular-assist-device-in-acute%C3%A2-myocardial-infarction
#17
MULTICENTER STUDY
Deepak Acharya, Renzo Y Loyaga-Rendon, Salpy V Pamboukian, José A Tallaj, William L Holman, Ryan S Cantor, David C Naftel, James K Kirklin
BACKGROUND: Patients with acute myocardial infarction (AMI) complicated by acute heart failure or cardiogenic shock have high mortality with conventional management. OBJECTIVES: This study evaluated outcomes of patients with AMI who received durable ventricular assist devices (VAD). METHODS: Patients in the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) registry who underwent VAD placement in the setting of AMI were included and compared with patients who received VAD for non-AMI indications...
April 26, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27102201/outcome-after-open-and-laparoscopic-aortic-surgery-in-matched-cohorts-using-propensity-score-matching
#18
COMPARATIVE STUDY
J-B Ricco, J Cau, F Biancari, M Desvergnes, N Lefort, R Belmonte, F Schneider
OBJECTIVE/BACKGROUND: To compare the post-operative and mid-term outcomes of laparoscopic aortic surgery with those of conventional aortic surgery performed by a surgical team trained in laparoscopic aortic surgery. METHODS: A prospective study was conducted between January 2006 and December 2011 with 228 consecutive patients having undergone aortic bypass surgery for either an abdominal aortic aneurysm (n = 139) or occlusive aorto-iliac disease (n = 89). Conventional open aortic surgery was carried out in 145 patients, and total laparoscopic repair in 83 patients...
August 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27056124/forward-and-back-aspiration-during-st-elevation-myocardial-infarction-a-feasibility-study
#19
Vasim Farooq, Patrick W Serruys, Ahmad H S Mustafa, Mamas A Mamas, Nadim Malik, Hafez A Alhous, Magdi El-Omar, Cara Hendry, Durgesh N Rana, David Shelton, Paul K Wright, Nadira Narine, Bernard Clarke, Bernard Keavney, Farzin Fath-Ordoubadi, Douglas G Fraser
AIMS: The inability to optimise stent expansion fully whilst simultaneously preventing distal embolisation during ST-elevation myocardial infarction (STEMI) remains a clinical conundrum. We aimed to describe a newly devised angiographic strategy of "forward" and "back" aspiration that leads to more complete thrombus removal and prevention of distal embolisation, to allow high-pressure post-dilatation of the implanted stent to be performed. METHODS AND RESULTS: Forward aspiration was conducted with a conventional aspiration thrombectomy catheter, with bail-out aspiration thrombectomy for angiographically persistent thrombus utilising the larger bore 6 Fr (0...
April 8, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27030600/prediction-and-impact-of-failure-of-transradial-approach-for-primary-percutaneous-coronary-intervention
#20
Eltigani Abdelaal, Jimmy MacHaalany, Guillaume Plourde, Alberto Barria Perez, Marie-Pier Bouchard, Melanie Roy, Jean-Pierre Déry, Ugo Déry, Gérald Barbeau, Éric Larose, Onil Gleeton, Bernard Noël, Josep Rodés-Cabau, Louis Roy, Olivier Costerousse, Olivier F Bertrand
OBJECTIVES: To determine predictors of failure of transradial approach (TRA) in patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), and develop a novel score specific for this population. METHODS: Consecutive patients with STEMI undergoing primary PCI in a tertiary care high-volume radial centre were included. TRA-PCI failure was categorised as primary (primary transfemoral approach (TFA)) or crossover (from TRA to TFA)...
June 15, 2016: Heart: Official Journal of the British Cardiac Society
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