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JOURNAL ARTICLE
Thivanka N Witharana, Ranu Baral, Vassilios S Vassiliou
BACKGROUND: Morphine is commonly used in the management of acute cardiogenic pulmonary oedema. The European Society of Cardiology (ESC) and National Institute for Health and Care Excellence (NICE) do not recommend the routine use of opioids in acute heart failure (AHF) due to dose-dependent side effects. However, the effect of morphine remains unclear. Our study aims to investigate the link between morphine use in acute cardiogenic pulmonary oedema and mortality. METHODS: PubMed and Embase databases were searched from inception to October 2021...
2022: Therapeutic Advances in Cardiovascular Disease
#22
RANDOMIZED CONTROLLED TRIAL
Rémi Coudroy, Jean-Pierre Frat, Stephan Ehrmann, Frédéric Pène, Maxens Decavèle, Nicolas Terzi, Gwenaël Prat, Charlotte Garret, Damien Contou, Arnaud Gacouin, Jeremy Bourenne, Christophe Girault, Christophe Vinsonneau, Jean Dellamonica, Guylaine Labro, Sébastien Jochmans, Alexandre Herbland, Jean-Pierre Quenot, Jérôme Devaquet, Dalila Benzekri, Emmanuel Vivier, Saad Nseir, Gwenhaël Colin, Didier Thevenin, Giacomo Grasselli, David Bougon, Mona Assefi, Claude Guérin, Thierry Lherm, Achille Kouatchet, Stephanie Ragot, Arnaud W Thille
BACKGROUND: Although non-invasive ventilation (NIV) is recommended for immunocompromised patients with acute respiratory failure in the intensive care unit (ICU), it might have deleterious effects in the most severe patients. High-flow nasal oxygen (HFNO) alone might be an alternative method to reduce mortality. We aimed to determine whether HFNO alone could reduce the rate of mortality at day 28 compared with HFNO alternated with NIV. METHODS: FLORALI-IM is a multicentre, open-label, randomised clinical trial conducted in 29 ICUs (28 in France and one in Italy)...
July 2022: Lancet Respiratory Medicine
#23
RANDOMIZED CONTROLLED TRIAL
Adi Osman, Gabriele Via, Roslanuddin Mohd Sallehuddin, Azma Haryaty Ahmad, Sow Kai Fei, Azlizawati Azil, Francesco Mojoli, Chan Pei Fong, Guido Tavazzi
AIMS: Non-invasive ventilation represents an established treatment for acute cardiogenic pulmonary oedema (ACPO) although no data regarding the best ventilatory strategy are available. We aimed to compare the effectiveness of helmet CPAP (hCPAP) and high flow nasal cannula (HFNC) in the early treatment of ACPO. METHODS AND RESULTS: Single-centre randomized controlled trial of patients admitted to the emergency department due to ACPO with hypoxemia and dyspnoea on face mask oxygen therapy...
December 18, 2021: European Heart Journal. Acute Cardiovascular Care
#24
JOURNAL ARTICLE
Rafiq Ahmed Bhat, Syed Manzoor Ali, Akanksha Rathi, Javaid Akhter Bhat, Raja Saqib Iqbal, Md Monowarul Islam, Syed Maqbool, Abhishek Tibrewal, Yongsheng Qu, You Zhang, Yuxiao Sun, Wentao Xiao, Chuanyu Gao
BACKGROUND: Acute myocardial infarction (AMI) complicated by cardiogenic shock (AMI-CS) or heart failure is associated with an unacceptably high in-hospital mortality of 33%-55% and a lost chance to accept PCI (Percutaneous Coronary Intervention). AIM: The aim of the study was to find out whether percutaneous hemodynamic support device Impella 2.5 improves prognosis of high-risk PCI patients or not. METHODS: This study was a case series involving six patients who underwent a Left Ventricular Assist Device (LVAD, Impella 2...
September 28, 2021: Perfusion
#25
REVIEW
Andrea Coppadoro, Elisabetta Zago, Fabio Pavan, Giuseppe Foti, Giacomo Bellani
A helmet, comprising a transparent hood and a soft collar, surrounding the patient's head can be used to deliver noninvasive ventilatory support, both as continuous positive airway pressure and noninvasive positive pressure ventilation (NPPV), the latter providing active support for inspiration. In this review, we summarize the technical aspects relevant to this device, particularly how to prevent CO2 rebreathing and improve patient-ventilator synchrony during NPPV. Clinical studies describe the application of helmets in cardiogenic pulmonary oedema, pneumonia, COVID-19, postextubation and immune suppression...
September 8, 2021: Critical Care: the Official Journal of the Critical Care Forum
#26
JOURNAL ARTICLE
Adrien Goldstein, Aymeric Antoine, Patrick Ray
Acute cardiogenic pulmonary oedema in the elderly does not differ fundamentally from that seen in the young patient. Appropriate pathways must be established, with regular nursing follow-up, to enable rapid detection and treatment of episodes of acute heart failure. The paramedical team plays an essential role in liaising with families, providing nursing care and listening to the patient at the bedside.
September 2021: Soins. Gérontologie
#27
REVIEW
Nuala J Meyer, Luciano Gattinoni, Carolyn S Calfee
Acute respiratory distress syndrome (ARDS) is an acute respiratory illness characterised by bilateral chest radiographical opacities with severe hypoxaemia due to non-cardiogenic pulmonary oedema. The COVID-19 pandemic has caused an increase in ARDS and highlighted challenges associated with this syndrome, including its unacceptably high mortality and the lack of effective pharmacotherapy. In this Seminar, we summarise current knowledge regarding ARDS epidemiology and risk factors, differential diagnosis, and evidence-based clinical management of both mechanical ventilation and supportive care, and discuss areas of controversy and ongoing research...
August 14, 2021: Lancet
#28
COMPARATIVE STUDY
Sebastian Rasch, Paul Schmidle, Sengül Sancak, Alexander Herner, Christina Huberle, Dominik Schulz, Ulrich Mayr, Jochen Schneider, Christoph D Spinner, Fabian Geisler, Roland M Schmid, Tobias Lahmer, Wolfgang Huber
Nearly 5% of patients suffering from COVID-19 develop acute respiratory distress syndrome (ARDS). Extravascular lung water index (EVLWI) is a marker of pulmonary oedema which is associated with mortality in ARDS. In this study, we evaluate whether EVLWI is higher in patients with COVID-19 associated ARDS as compared to COVID-19 negative, ventilated patients with ARDS and whether EVLWI has the potential to monitor disease progression. EVLWI and cardiac function were monitored by transpulmonary thermodilution in 25 patients with COVID-19 ARDS subsequent to intubation and compared to a control group of 49 non-COVID-19 ARDS patients...
June 1, 2021: Scientific Reports
#29
RANDOMIZED CONTROLLED TRIAL
Aurélien Dinh, Jacques Ropers, Clara Duran, Benjamin Davido, Laurène Deconinck, Morgan Matt, Olivia Senard, Aurore Lagrange, Sabrina Makhloufi, Guillaume Mellon, Victoire de Lastours, Frédérique Bouchand, Emmanuel Mathieu, Jean-Emmanuel Kahn, Elisabeth Rouveix, Julie Grenet, Jennifer Dumoulin, Thierry Chinet, Marion Pépin, Véronique Delcey, Sylvain Diamantis, Daniel Benhamou, Virginie Vitrat, Marie-Christine Dombret, Bertrand Renaud, Christian Perronne, Yann-Erick Claessens, José Labarère, Jean-Pierre Bedos, Philippe Aegerter, Anne-Claude Crémieux
BACKGROUND: Shortening the duration of antibiotic therapy for patients admitted to hospital with community-acquired pneumonia should help reduce antibiotic consumption and thus bacterial resistance, adverse events, and related costs. We aimed to assess the need for an additional 5-day course of β-lactam therapy among patients with community-acquired pneumonia who were stable after 3 days of treatment. METHODS: We did this double-blind, randomised, placebo-controlled, non-inferiority trial (the Pneumonia Short Treatment [PTC]) in 16 centres in France...
March 27, 2021: Lancet
#30
JOURNAL ARTICLE
Christophe Vandenbriele, Tim Balthazar, James Wilson, Tom Adriaenssens, Simon Davies, Walter Droogne, Christophe Dubois, Ana Francisca Caetano, Kaatje Goetschalckx, Steven Jacobs, Stefan Janssens, Stephane Ledot, Bart Meyns, Hatem Soliman-Aboumarie, Peter Verbrugghe, Susanna Price
AIMS: Patients presenting with cardiogenic shock (CS) related to acute, severe mitral regurgitation (MR) are often considered too ill for immediate surgical intervention. Therefore, other less invasive techniques for haemodynamic stabilization should be explored. The purpose of this exploratory study was to investigate the feasibility and outcomes in patients with CS due to severe MR by using a novel approach combining haemodynamic stabilization with left Impella-support plus MR-reduction using MitraClip®...
May 25, 2021: European Heart Journal. Acute Cardiovascular Care
#31
JOURNAL ARTICLE
Cristina Dominedò, Emilio D'Avino, Alessandra Martinotti, Emiliano Cingolani
Background: Pheochromocytoma is a rare catecholamine-producing tumour that classically displays clinical manifestations related to alpha-adrenergic stimulation, including paroxysmal or sustained hypertension. However, it may occasionally be complicated by life-threatening crisis, leading to refractory acute heart dysfunction in the most severe cases. Case summary: A 28-year-old woman was admitted to intensive care unit due to hypertensive crisis causing pulmonary oedema, Takotsubo cardiomyopathy, and metabolic acidosis...
February 2021: European Heart Journal. Case Reports
#32
MULTICENTER STUDY
Muhammad Rashid, Jianhua Wu, Adam Timmis, Nick Curzen, Sarah Clarke, Azfar Zaman, James Nolan, Ahmad Shoaib, Mohamed O Mohamed, Mark A de Belder, John Deanfield, Chris P Gale, Mamas A Mamas
BACKGROUND: Patients with underlying cardiovascular disease and coronavirus disease 2019 (COVID-19) infection are at increased risk of morbidity and mortality. OBJECTIVES: This study was designed to characterize the presenting profile and outcomes of patients hospitalized with acute coronary syndrome (ACS) and COVID-19 infection. METHODS: This observational cohort study was conducted using multisource data from all acute NHS hospitals in England...
July 2021: Journal of Internal Medicine
#33
REVIEW
David J. Kurz, Franz Robert Eberli
Coronavirus disease 2019 (COVID-19) is primarily a pulmonary disease, but also affects the cardiovascular system in multiple ways. In this review, we will summarise and put into perspective findings and debates relating to the diverse aspects of cardiovascular involvement of COVID-19. We will review evidence for the role of the renin-angiotensin-aldosterone system (RAAS), the risk of pre-existing cardiovascular disease in COVID-19 susceptibility and course, and the mechanism of acute and long-term myocardial injury...
December 14, 2020: Swiss Medical Weekly
#34
JOURNAL ARTICLE
Héctor González-Pacheco, Amada Álvarez-Sangabriel, Carlos Martínez-Sánchez, José L Briseño-Cruz, Alfredo Altamirano-Castillo, Salvador Mendoza-García, Daniel Manzur-Sandoval, Luis M Amezcua-Guerra, Julio Sandoval, Rafael Bojalil, Diego Araiza-Garaygordobil, Daniel Sierra-Lara, Carlos A Guiza-Sánchez, Rodrigo Gopar-Nieto, Camelia Cruz-Rodríguez, José J Valdivia-Nuño, Brandon Salas-Teles, Alexandra Arias-Mendoza
AIMS: Little is known regarding acute heart failure (AHF) clinical characteristics and its hospital outcome in Latin America. This study sought to assess the prevalence of, and identify differences among, in-hospital outcomes in patients hospitalized for AHF who were stratified by clinical phenotype at a hospital in Latin America. METHODS AND RESULTS: This is a retrospective cohort study of patients with AHF who were hospitalized in the coronary care unit of a Latin American teaching hospital from January 2006 to December 2018...
February 2021: ESC Heart Failure
#35
JOURNAL ARTICLE
Arthur Hacquin, Sophie Putot, Jérémy Barben, Frédéric Chagué, Marianne Zeller, Yves Cottin, Patrick Manckoundia, Alain Putot
AIMS: In the older population, acute heart failure is a frequent, life-threatening complication of COVID-19 that requires urgent specific care. We aimed to explore the impact of point-of-care chest ultrasound (CUS) use in older bedridden inpatients during the COVID-19 pandemic as a tool to distinguish between cardiogenic pulmonary oedema and isolated viral pneumonia-related dyspnoea. METHODS AND RESULTS: This prospective series included 16 patients aged 75 or older, hospitalized for acute dyspnoea in an acute geriatric unit of a university hospital and testing positive for a SARS-Cov2 infection...
December 2020: ESC Heart Failure
#36
JOURNAL ARTICLE
Johannes Grand, Jacob Eifer Møller, Søren Boesgaard, Finn Gustafsson, Lars Køber, Jesper Kjærgaard, Christian Hassager
Acute heart failure is a common and severe condition in Danish emergency hospitals. Hypertensive pulmonary oedema, cardiogenic shock and congestive heart failure are the most common phenotypes. The aim of this review is to summarise the most recent international guidelines for acute triage and treatment of acute heart failure. Afterload is reduced with nitrates, congestion is treated with intravenous loop-diuretics, and in selected patients, cardiac output could be increased by inotropic drugs or mechanical support devices...
October 5, 2020: Ugeskrift for Laeger
#37
MULTICENTER STUDY
Daniel Fernández-Bergés, Irene R Degano, Reyes Gonzalez Fernandez, Isaac Subirana, Joan Vila, Manuel Jiménez-Navarro, Silvia Perez-Fernandez, Mercé Roqué, Antoni Bayes-Genis, Francisco Fernandez-Aviles, Antonio Mayorga, Vicente Bertomeu-Gonzalez, Juan Sanchis, Marcos Rodríguez Esteban, Antonio Sanchez-Hidalgo, Esther Sanchez-Insa, Ane Elorriaga, Emad Abu Assi, Alberto Nuñez, Jose Manuel Garcia Ruiz, Pedro Morrondo Valdeolmillos, Daniel Bosch-Portell, Iñaki Lekuona, Andres Carrillo-Lopez, Alberto Zamora, Berta Vega-Hernandez, Javier Alameda Serrano, Catalina Rubert, Luis Ruiz-Valdepeñas, Laura Quintas, Luis Rodríguez-Padial, Jessica Vaquero, Luis Martinez Dolz, Jose A Barrabes, Pedro L Sanchez, Alessandro Sionis, Julio Martí-Almor, Roberto Elosua, Rosa-María Lidon, David Garcia-Dorado, Jaume Marrugat
OBJECTIVE: Primary percutaneous coronary intervention (P-PCI) has demonstrated its efficacy in patients with ST segment elevation myocardial infarction (STEMI). However, patients with STEMI ≥75 years receive less P-PCI than younger patients despite their higher in-hospital morbimortality. The objective of this analysis was to determine the effectiveness of P-PCI in patients with STEMI ≥75 years. METHODS: We included 979 patients with STEMI ≥75 years, from the ATención HOspitalaria del Síndrome coronario study, a registry of 8142 consecutive patients with acute coronary syndrome admitted at 31 Spanish hospitals in 2014-2016...
August 2020: Open Heart
#38
Harish Sharma, Sudhakar George
Background: Left ventricular thrombus (LVT) is a complication of acute myocardial infarction (AMI) due to localised haemostasis. LVT is typically seen 3-12 days following AMI and is seldom seen within the first 24 hours. LVT increases the risk of mortality due to systemic thromboembolism. Patients with Coronavirus Disease-19 (COVID-19) are potentially hypercoagulable and this may promote early development of LVT. Case: A 50-year-old man with no past medical history was admitted with a severe diabetic ketoacidosis following a 4-day history of cough and fever...
2020: Case Reports in Cardiology
#39
JOURNAL ARTICLE
Dani-Louise Dixon, Mark D Lawrence, Shailesh Bihari, Carmine G De Pasquale, Kim M Griggs, Andrew D Bersten
BACKGROUND: Hydrostatic lung injury followed by pulmonary remodelling variably complicates cardiogenic acute pulmonary oedema (APO). Pulmonary remodelling may be regulated by the balance between distinct phenotypes of pulmonary macrophages; activated/inflammatory (M1), and reparative/anti-inflammatory (M2), derived from circulating monocyte populations. The aim of this study was to identify biomarkers in peripheral blood that are consistent with hydrostatic lung injury and pulmonary remodelling in APO and which follow the variable clinical course...
March 2021: Heart, Lung & Circulation
#40
REVIEW
Simone Maria Navarra, Maria Teresa Congedo, Mariano Alberto Pennisi
BACKGROUND: Non-invasive ventilation (NIV) is increasingly being used to treat episodes of acute respiratory failure not only in critical care and respiratory wards, but also in emergency departments. AIM: Aim of this review is to summarize the current indications for the management of NIV for respiratory failure. METHODS: Current literature about the topic was reviewed and critically reported to describe the rationale and physiologic advantages of NIV in various situations of respiratory failure...
2020: Reviews on Recent Clinical Trials
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