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Cardiac Guidelines

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https://www.readbyqxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#1
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29138760/cardiac-surgery-after-heart-transplantation-elective-operation-or-last-exit-strategy
#2
Johannes Goekler, Andreas Zuckermann, Emilio Osorio, Faris F Brkic, Keziban Uyanik-Uenal, Guenther Laufer, Arezu Aliabadi-Zuckermann
Background: Because of improved long-term survival after heart transplantation (HTx), late graft pathologies such as valvular disease or cardiac allograft vasculopathy (CAV) might need surgical intervention to enhance longer survival and ensure quality of life. To this date, there exist no guidelines for indication of cardiac surgery other than retransplantation after HTx. Methods: In this retrospective, single-center study, we evaluated patients who underwent cardiac surgery after HTx at our institution...
October 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29138292/impact-of-regionalization-of-st-elevation-myocardial-infarction-care-on-treatment-times-and-outcomes-for-emergency-medical-services-transported-patients-presenting-to-hospitals-with-percutaneous-coronary-intervention-mission-lifeline-accelerator-2
#3
James G Jollis, Hussein R Al-Khalidi, Mayme L Roettig, Peter B Berger, Claire C Corbett, Shannon Doerfler, Christopher B Fordyce, Timothy D Henry, Lori Hollowell, Zainab Magdon-Ismail, Ajar Kochar, James J McCarthy, Lisa Monk, Peter K O'Brien, Thomas D Rea, Jay Shavadia, Jacqueline Tamis-Holland, B Hadley Wilson, Khaled M Ziada, Christopher B Granger
Background: Regional variations in reperfusion times and mortality in patients with ST-segment elevation myocardial infarction (STEMI) are influenced by differences in coordinating care between emergency medical services (EMS) and hospitals. Building on the Accelerator-1 Project, we hypothesized that time to reperfusion could be further reduced with enhanced regional efforts. Methods: Between April 2015 and March 2017, we worked with 12 metropolitan regions across the United States with 132 PCI-capable hospitals and 946 EMS agencies...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29136561/calibrated-automated-thrombogram-values-in-infants-with-cardiac-surgery-before-and-after-cardiopulmonary-bypass
#4
Alessandra Rizza, Giovina Di Felice, Rosa Luciano, Ottavia Porzio, Ombretta Panizzon, Maurizio Muraca, Paola Cogo
INTRODUCTION: Impaired thrombin generation has been associated to increase bleeding after cardiac surgery with cardiopulmonary bypass (CPB), especially in children. The aim of this study was to evaluate standard coagulation assay, thrombin generation by calibrated automated thrombogram (CAT), thromboelastography (TEG) and procoagulant phospholipids (PPL) activity in infants undergoing cardiac surgery with CPB. MATERIALS AND METHODS: Prospective observational study performed in children aged <24months undergoing cardiac surgery with CPB...
September 21, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29135862/management-of-sigmoid-sinus-associated-pulsatile-tinnitus-a-systematic-review-of-the-literature
#5
Alan C Wang, Avery N Nelson, Cassandra Pino, Peter F Svider, Robert S Hong, Eleanor Chan
OBJECTIVES: Although studies demonstrate 4 to 20% of patients with pulsatile tinnitus (PT) have associated sigmoid sinus anomalies, no consensus exists regarding optimal management. Our objective was to perform a systematic review exploring surgical and endovascular intervention of PT caused by sigmoid sinus anomalies. DATA SOURCES/EXTRACTION: A systematic review was performed using the Preferred Reporting Systems for Systematic Reviews and Meta-Analysis guidelines for reporting of results, with a target population encompassing patients with PT and either sigmoid sinus diverticulum or sigmoid wall dehiscence...
December 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/29135805/failure-of-invasive-airway-placement-on-the-first-attempt-is-associated-with-progression-to-cardiac-arrest-in-pediatric-acute-respiratory-compromise
#6
Hannah R Stinson, Vijay Srinivasan, Alexis A Topjian, Robert M Sutton, Vinay M Nadkarni, Robert A Berg, Tia T Raymond
OBJECTIVES: The aim of this study was to describe the proportion of acute respiratory compromise events in hospitalized pediatric patients progressing to cardiopulmonary arrest, and the clinical factors associated with progression of acute respiratory compromise to cardiopulmonary arrest. We hypothesized that failure of invasive airway placement on the first attempt (defined as multiple attempts at tracheal intubation, and/or laryngeal mask airway placement, and/or the creation of a new tracheostomy or cricothyrotomy) is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest...
November 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#7
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135620/safety-of-a-1-hour-rule-out-high-sensitive-troponin-t-protocol-in-patients-with-chest-pain-at-the-emergency-department
#8
E Röttger, S de Vries-Spithoven, J B Reitsma, A Limburg, C E E van Ofwegen-Hanekamp, A W Hoes, J M Poldervaart
BACKGROUND: The 1-hour rule-out high-sensitive cardiac troponin T protocol (hs-cTnT), in which a serial troponin measurement is performed 1 hour after the first to assess the possibility of acute coronary syndrome (ACS), has been implemented in the European guidelines in 2015. Our aim was to assess the safety of this protocol in low-risk patients in the Emergency Department (ED) when implemented in daily practice. METHODS: Patients with acute chest pain presenting to the ED of our hospital and younger than 75 years were included (May 2013 to October 2014, The Netherlands)...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135619/the-heart-pathway-and-hospital-cost-savings
#9
Amy A Yau, Long T Nguyendo, LaKeesha L Lockett, Edward Michaud
Chest pain is a common complaint in emergency departments. Several guidelines and tools exist to help the clinician determine need for hospitalization. For low-risk patients, clinical judgment can underestimate a patient's risk of major adverse cardiac event. Implementation of an advanced diagnostic protocol with the HEART Pathway can reduce hospital cost. For our academic institution, we saw an approximate $1 million in total savings during the initial implementation year along with increased outpatient visits...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135618/pathway-for-the-management-of-hyperglycemia-in-the-cardiac-care-unit
#10
Seyed Hamed Hosseini Dehkordi, Jeanine Albu, Emad F Aziz, Eyal Herzog
Inpatient hyperglycemia has been associated with increased morbidity and mortality in critically ill patients. Optimal control of blood glucose (BG) levels using insulin infusion protocols has been shown to improve clinical outcomes. Protocols have been developed to prescribe a safe and effective rate of insulin infusion for optimal control of BG levels; however, a major obstacle in their implementation is their complexity. We have revised and updated our previously published pathway for the management of hyperglycemia, which introduces the "wheel" concept for insulin dosing...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135530/should-percussion-pacing-have-a-role-in-perioperative-advanced-cardiac-life-support-a-case-report
#11
Chris Giordano, Jordan Miller, Ilan Keidan
Percussion pacing involves using one's fist to repeatedly strike a patient's left sternal border in a rhythmic manner. The resulting increase in ventricular pressure can trigger myocardial depolarization and subsequent contraction. We describe the successful treatment of acute preoperative symptomatic sinus bradycardia with percussion pacing in a 63-year-old patient scheduled for placement of a gastric feeding tube after trauma involving spinal cord injury. Although no longer included in current advanced cardiovascular life support guidelines, percussion pacing may be a suitable alternative to chest compressions in multitrauma cases where the force of compressions could cause further complications...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#12
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29131707/plasma-neutrophil-gelatinase-associated-lipocalin-measured-immediately-after-restoration-of-spontaneous-circulation-predicts-acute-kidney-injury-in-cardiac-arrest-survivors-who-underwent-therapeutic-hypothermia
#13
Dong Hun Lee, Byung Kook Lee, Yong Soo Cho, Yong Hun Jung, Sung Min Lee, Jung Soo Park, Kyung Woon Jeung
Early diagnosis of acute kidney injury (AKI) after cardiac arrest (CA) is challenging. We aimed to identify the diagnostic and prognostic performance of neutrophil gelatinase-associated lipocalin (NGAL) for AKI and its clinical outcomes. A retrospective observational study, involving adult comatose CA survivors treated with therapeutic hypothermia between May 2013 and December 2016, was conducted. AKI was classified according to the guidelines of Kidney Disease Improving Global Outcomes. NGAL levels were measured after return of spontaneous circulation (ROSC)...
November 13, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29131444/native-t1-reference-values-for-nonischemic-cardiomyopathies-and-populations-with-increased-cardiovascular-risk-a-systematic-review-and-meta-analysis
#14
REVIEW
Maaike van den Boomen, Riemer H J A Slart, Enzo V Hulleman, Rudi A J O Dierckx, Birgitta K Velthuis, Pim van der Harst, David E Sosnovik, Ronald J H Borra, Niek H J Prakken
BACKGROUND: Although cardiac MR and T1 mapping are increasingly used to diagnose diffuse fibrosis based cardiac diseases, studies reporting T1 values in healthy and diseased myocardium, particular in nonischemic cardiomyopathies (NICM) and populations with increased cardiovascular risk, seem contradictory. PURPOSE: To determine the range of native myocardial T1 value ranges in patients with NICM and populations with increased cardiovascular risk. STUDY TYPE: Systemic review and meta-analysis...
November 13, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29130567/treatment-strategies-in-coronary-microvascular-dysfunction-a-systematic-review-of-interventional-studies
#15
Hannah E Suhrs, Marie M Michelsen, Eva Prescott
Coronary microvascular dysfunction has been associated with a wide spectrum of diseases and conditions, and it has proven to be a strong prognostic marker of morbidity and mortality. Despite increased attention guideline-based treatment recommendations are lacking. We performed a systematic review of pharmacological and non-pharmacological interventions to improve coronary perfusion, assessed by intracoronary Doppler, transthoracic Doppler echocardiography, positron emission tomography, cardiac magnetic resonance imaging, transthoracic contrast perfusion echocardiography and dilution techniques...
November 11, 2017: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29129562/preoperative-use-of-oral-beta-adrenergic-blocking-agents-and-the-incidence-of-new-onset-atrial-fibrillation-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#16
REVIEW
Paul Min Thein, Kyle White, Khyati Banker, Carole Lunny, Sam Mirzaee, Arthur Nasis
BACKGROUND: Current epidemiological data suggests that postoperative atrial fibrillation or atrial flutter (POAF) causes significant morbidity and mortality after cardiac surgery. The literature for prophylactic management of POAF is limited, resulting in the lack of clear guidelines on management recommendations. AIM: To examine the efficacy of prophylactic rate control agents in reducing the incidence of new-onset POAF in patients undergoing elective cardiac surgery...
October 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29129396/sex-difference-between-target-levels-of-cholesterol-related-parameters-and-post-pci-long-term-clinical-outcomes-from-the-fu-registry
#17
Yuta Matsuoka, Amane Ike, Masahiro Ogawa, Kouki Gondo, Kazuyuki Shirai, Makoto Sugihara, Daisuke Nose, Hiroaki Nishikawa, Atsushi Iwata, Akira Kawamura, Ken Mori, Bo Zhang, Shin'ichiro Yasunaga, Shin-Ichiro Miura, Keijiro Saku
BACKGROUND: Since single lipid parameters are too weak to predict the risk of coronary artery disease, we examined whether the allocation of patients into four groups based on achievement of the target levels set by the Japan Atherosclerosis Guidelines at the time of percutaneous coronary intervention (PCI) would reveal different long-term (5 years) clinical outcomes in males and females. METHODS: The results of a 5-year follow-up study are summarized as FU-Registry, Long-Term Clinical Outcome Results...
November 9, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29129249/association-between-hospital-rates-of-early-do-not-resuscitate-orders-and-favorable-neurological-survival-among-survivors-of-inhospital-cardiac-arrest
#18
Timothy J Fendler, John A Spertus, Kevin F Kennedy, Paul S Chan
BACKGROUND: Current guidelines recommend deferring prognostication for 48 to 72 hours after resuscitation from inhospital cardiac arrest. It is unknown whether hospitals vary in making patients who survive an arrest Do-Not-Resuscitate (DNR) early after resuscitation and whether a hospital's rate of early DNR is associated with its rate of favorable neurological survival. METHODS: Within Get With the Guidelines-Resuscitation, we identified 24,899 patients from 236 hospitals who achieved return of spontaneous circulation (ROSC) after inhospital cardiac arrest between 2006 and 2012...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29126584/comparison-of-4-cardiac-risk-calculators-in-predicting-postoperative-cardiac-complications-after-noncardiac-operations
#19
Steven L Cohn, Nerea Fernandez Ros
The 2014 American College of Cardiology/American Heart Association Perioperative Guidelines suggest using the Revised Cardiac Risk Index, myocardial infarction or cardiac arrest, or American College of Surgeons-National Surgical Quality Improvement Program calculators for combined patient-surgical risk assessment. There are no published data comparing their performance. This study compared these risk calculators and a reconstructed Revised Cardiac Risk Index in predicting postoperative cardiac complications, both during hospitalization and 30 days after operation, in a patient cohort who underwent select surgical procedures in various risk categories...
October 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29123876/do-not-attempt-resuscitation-order-in-japan
#20
Yoshihide Nakagawa, Sadaki Inokuchi, Nobuo Kobayashi, Yoshinobu Ohkubo
Aim: In Japan, the do not attempt resuscitation (DNAR) order is practised routinely even though no related laws or guidelines exist. This study aimed to clarify the current status of DNAR, reveal existing DNAR-related issues, and improve the application of DNAR. Methods: A questionnaire survey of medical institutions in Kanagawa Prefecture (total population, 9,120,000) about the current status of DNAR was carried out. Results: The results showed that DNAR has been practised at approximately 90% of the hospitals surveyed, but only about 30% have developed in-hospital DNAR guidelines...
July 2017: Acute Medicine & Surgery
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