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Heart failure intensive care

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https://www.readbyqxmd.com/read/28806965/decreased-circulating-dihomo-gamma-linolenic-acid-levels-are-associated-with-total-mortality-in-patients-with-acute-cardiovascular-disease-and-acute-decompensated-heart-failure
#1
Shohei Ouchi, Tetsuro Miyazaki, Kazunori Shimada, Yurina Sugita, Megumi Shimizu, Azusa Murata, Takao Kato, Tatsuro Aikawa, Shoko Suda, Tomoyuki Shiozawa, Masaru Hiki, Shuhei Takahashi, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
BACKGROUND: Polyunsaturated fatty acids (PUFAs) have important roles in the pathogenesis of cardiovascular diseases. However, the clinical significance of omega-6 PUFAs in acute cardiovascular disease remains unknown. METHODS: We enrolled 417 consecutive patients with acute cardiovascular disease admitted to the cardiac intensive care unit at Juntendo University Hospital between April 2012 and October 2013. We investigated the association between serum PUFA levels and long-term mortality...
August 14, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28803356/the-prognostic-impact-of-malnutrition-in-patients-with-severely-decompensated-acute-heart-failure-as-assessed-using-the-prognostic-nutritional-index-pni-and-controlling-nutritional-status-conut-score
#2
Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Suguru Nishigoori, Saori Uchiyama, Kuniya Asai, Wataru Shimizu
Patients with heart failure (HF) are sometimes classified as malnourished, but the prognostic value of nutritional status in acute HF (AHF) remains largely unstudied. 1214 patients who were admitted to the intensive care unit between January 2000 and June 2016 were screened based on their serum albumin, lymphocyte count, and total cholesterol measures. A total of 458 HF patients were enrolled in this study. The Prognostic Nutritional Index (PNI) is calculated as 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm(3)) (lower = worse)...
August 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28802997/prophylactic-use-of-an-intra-aortic-balloon-pump-in-a-high-risk-patient-with-peripartum-cardiomyopathy-requiring-cesarean-delivery
#3
R S Samalavicius, L Puodziukaite, I Radaviciute, I Norkiene, K Urbonas, I Misiuriene, V Janusauskas, A Zorinas, K Rucinskas, P Serpytis
The use of intra-aortic balloon counter-pulsation for circulatory support in pregnant women with cardiac failure is limited to several case reports. Few publications have addressed the use of intra-aortic balloon counter-pulsation during delivery. We report a case using prophylactic intra-aortic counter-pulsation during the management of a cesarean delivery in a patient with peripartum cardiomyopathy. A 28-year-old primigravid female at 37weeks of gestation was admitted with signs of worsening heart failure, and transthoracic echocardiography revealed a decreased left ventricular ejection fraction of 25%...
July 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28794356/early-onset-severe-chronic-obstructive-pulmonary-disease-with-pulmonary-hypertension-that-was-likely-induced-by-toluene-exposure
#4
Konomi Kobayashi, Manabu Suzuki, Shota Yamamoto, Keisuke Ueno, Eriko Miyawaki, Ikuo Takazawa, Ayako Shiozawa, Teruhiko Sato, Masayuki Hojo, Haruhito Sugiyama
Early-onset pulmonary emphysema is uncommon and its pathogenesis is poorly defined. A 30-year-old man was admitted to our intensive care unit with severe respiratory failure. Besides smoking heavily since the 14 years of age, he had habitually inhaled organic solvents, such as toluene, in his adolescence. High-resolution computed tomography showed evident pulmonary emphysema throughout the lung fields. Based on the findings of right heart catheterization, he was diagnosed with an acute exacerbation of chronic obstructive pulmonary disease complicated with pulmonary hypertension...
August 10, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28794121/changes-in-primary-noncardiac-diagnoses-over-time-among-elderly-cardiac-intensive-care-unit-patients-in-the-united-states
#5
Shashank S Sinha, Michael W Sjoding, Devraj Sukul, Hallie C Prescott, Theodore J Iwashyna, Hitinder S Gurm, Colin R Cooke, Brahmajee K Nallamothu
BACKGROUND: Early reports suggest the number of cardiac intensive care unit (CICU) patients with primary noncardiac diagnoses is rising in the United States, but no national data currently exist. We examined changes in primary noncardiac diagnoses among elderly patients admitted to a CICU during the past decade. METHODS AND RESULTS: Using 2003 to 2013 Medicare data, we grouped elderly patients admitted to CICUs into 2 categories based on principal diagnosis at discharge: (1) primary noncardiac diagnoses and (2) primary cardiac diagnoses...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28793902/30-year-experience-of-fontan-surgery-single-centre-s-data
#6
Laurynas Bezuska, Virgilijus Lebetkevicius, Rita Sudikiene, Daina Liekiene, Virgilijus Tarutis
BACKGROUND: The Fontan procedure has been modified several times since it was introduced into practice in 1968. As many patients now survive to adulthood, attention is directed towards their clinical status and late morbidity. We report our surgical experience of 30 years in Fontan procedures. METHODS: From January 1985 to January 2015, 80 patients underwent Fontan surgery. Twenty-one patients received an atrio-pulmonary Fontan (Group I), four patients underwent total cavopulmonary connection (TCPC) with an intra-atrial lateral tunnel (Group II), six patients received extra-cardiac TCPC with an aortic homograft (group III) and 49 patients received extra-cardiac TCPC with an expanded polytetrafluoroethylene conduit...
August 9, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28780656/hus-induced-cardiac-and-circulatory-failure-is-reversible-using-cardiopulmonary-bypass-as-rescue
#7
René F Andersen, Jesper V Bjerre, Johan V Povlsen, Mette Veien, Konstantinos Kamperis, Søren Rittig
BACKGROUND: Extra-renal involvement in hemolytic uremic syndrome (HUS) includes gastrointestinal, pancreatic, hepatic, neurological and cardiac manifestations. The current 3-5% mortality rate in HUS patients is primarily attributed to complications related to the central nervous system and the heart. In this brief report, we illustrate that severe cardiac involvement in a patient with HUS is potentially reversible using cardiopulmonary bypass as rescue. CASE-DIAGNOSIS/TREATMENT: A 12-year-old boy was diagnosed with enterohemorrhagic Escherichia coli-induced HUS related to E...
August 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28772186/an-evaluation-of-involving-family-caregivers-in-the-self-care-of-heart-failure-patients-on-hospital-readmission-randomised-controlled-trial-the-family-study
#8
Hiba Deek, Sungwon Chang, Phillip J Newton, Samar Noureddine, Sally C Inglis, Ghina Al Arab, Samer Kabbani, Wael Chalak, Nadim Timani, Peter S Macdonald, Patricia M Davidson
BACKGROUND: The prevalence of heart failure is increasing in Lebanon but to date there is no systematic evaluation of a disease management intervention. OBJECTIVE: The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission. DESIGN: A multi-site, block randomised controlled trial. SETTINGS: The study was conducted over a 13-month period in three tertiary medical centres in Beirut and Mount Lebanon, Lebanon...
July 25, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28765741/experience-with-mechanical-circulatory-support-for-medically-intractable-low-cardiac-output-in-a-pediatric-intensive-care-unit
#9
Jung Bin Park, Jae Gun Kwak, Hong-Gook Lim, Woong-Han Kim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND AND OBJECTIVES: Mechanical circulatory support with extracorporeal membrane oxygenation (ECMO) and ventricular assist device has always been the optimal choice for treating the majority of medically intractable low cardiac output case. We retrospectively investigated our institution's outcomes and variables associated with a high risk of mortality. SUBJECTS AND METHODS: From 1999 to 2014, 86 patients who were of pediatric age or had grown-up congenital heart disease underwent mechanical circulatory support for medically intractable low cardiac output in our pediatric intensive care unit...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28760891/influence-of-beta-lactam-infusion-strategy-on-acute-kidney-injury
#10
Sarah E Cotner, W Cliff Rutter, Donna R Burgess, Katie L Wallace, Craig A Martin, David S Burgess
Background Limited literature is available assessing nephrotoxicity with prolonged beta-lactam infusions. This study compared the incidence of acute kidney injury (AKI) associated with a prolonged beta-lactam infusion (PI) or an intermittent infusion.Methods. This was a retrospective, matched cohort study at an academic medical center from July 2006 to September 2015. Adult patients who received piperacillin-tazobactam (TZP), cefepime (FEP), or meropenem (MEM) for at least 48 hours were evaluated. Patients were excluded for pre-existing renal dysfunction or pregnancy...
July 31, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28760204/effects-of-serelaxin-on-the-outcome-of-patients-with-or-without-substantial-peripheral-edema-a-subgroup-analysis-from-the-relax-ahf-trial
#11
Claudio Gimpelewicz, Marco Metra, John G F Cleland, Peter Szecsödy, Chuan-Chuan Chang Wun, Leandro Boer-Martins, Gad Cotter, Beth A Davison, Gary Michael Felker, Gerasimos Filippatos, Barry H Greenberg, Peter Pang, Piotr Ponikowski, Thomas Severin, Adrian A Voors, John R Teerlink
BACKGROUND: Acute heart failure (AHF) is a heterogeneous disorder, with most of the patients presenting with breathlessness along with varying degrees of peripheral edema. The presence of peripheral edema suggests that volume overload is the cause of decompensation leading to AHF, whereas breathlessness in the absence of edema may reflect a "vascular phenotype." This analysis investigated the characteristics, therapeutic response, and outcome of patients with AHF, with and without overt peripheral edema in the RELAX-AHF trial...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28751839/the-future-of-telemedicine-for-the-management-of-heart-failure-patients-a-consensus-document-of-the-italian-association-of-hospital-cardiologists-a-n-m-c-o-the-italian-society-of-cardiology-s-i-c-and-the-italian-society-for-telemedicine-and-ehealth-digital
#12
Andrea Di Lenarda, Giancarlo Casolo, Michele Massimo Gulizia, Nadia Aspromonte, Simonetta Scalvini, Andrea Mortara, Gianfranco Alunni, Renato Pietro Ricci, Roberto Mantovan, Giancarmine Russo, Gian Franco Gensini, Francesco Romeo
Telemedicine applied to heart failure patients is a tool for recording and providing remote transmission, storage and interpretation of cardiovascular parameters and/or useful diagnostic images to allow for intensive home monitoring of patients with advanced heart failure, or during the vulnerable post-acute phase, to improve patient's prognosis and quality of life. Recently, several meta-analyses have shown that telemedicine-supported care pathways are not only effective but also economically advantageous...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28749055/a-failure-to-be-candid
#13
Jennifer McGuirl
I was a second-year neonatal-perinatal fellow in a meeting between other members of the neonatal intensive care team and parents who had just received devastating news about their planned-for and highly desired baby, born after what had been an uncomplicated pregnancy. At home, a little sister was waiting to meet her new brother. These conversations are never easy, but this one I found particularly disturbing. John had been born at term via emergency cesarean section after his mother, Muriel, had come for a routine obstetrical visit and reported decreased fetal movement...
July 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28727607/new-onset-heart-failure-and-mortality-in-hospital-survivors-of-sepsis-related-left-ventricular-dysfunction
#14
Saraschandra Vallabhajosyula, Jacob C Jentzer, Jeffrey B Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T Poterucha, Kianoush Kashani, Joseph G Murphy, Ognjen Gajic, Rahul Kashyap
BACKGROUND: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72 hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#15
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/28706970/reversibility-of-frailty-after-bridge-to-transplant-ventricular-assist-device-implantation-or-heart-transplantation
#16
Sunita R Jha, Malin K Hannu, Phillip J Newton, Kay Wilhelm, Christopher S Hayward, Andrew Jabbour, Eugene Kotlyar, Anne Keogh, Kumud Dhital, Emily Granger, Mark Connellan, Paul Jansz, Phillip M Spratt, Elyn Montgomery, Angela Smith, Michelle Harkess, Peta Tunicliff, Patricia M Davidson, Peter S Macdonald
BACKGROUND: We recently reported that frailty is independently predictive of increased mortality in patients with advanced heart failure referred for heart transplantation (HTx). The aim of this study was to assess the impact of frailty on short-term outcomes after bridge-to-transplant ventricular assist device (BTT-VAD) implantation and/or HTx and to determine if frailty is reversible after these procedures. METHODS: Between August 2013 and August 2016, 100 of 126 consecutive patients underwent frailty assessment using Fried's Frailty Phenotype before surgical intervention: 40 (21 nonfrail, 19 frail) BTT-VAD and 77 (60 nonfrail, 17 frail) HTx-including 17 of the 40 BTT-VAD supported patients...
July 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28704244/implementation-of-a-standardized-transfusion-protocol-for-cardiac-patients-treated-with-venoarterial-extracorporeal-membrane-oxygenation-is-associated-with-decreased-blood-component-utilization-and-may-improve-clinical-outcome
#17
Christine M Cahill, Neil Blumberg, Amy E Schmidt, Peter A Knight, Amber L Melvin, Howard T Massey, Joseph M Delehanty, Seth B Zebrak, Majed A Refaai
BACKGROUND: Extracorporeal membrane oxygenation supplies oxygenated blood to the body supporting the heart and lungs. Survival rates of 20% to 50% are reported among patients receiving ECMO for cardiac arrest, severe cardiogenic shock, or failure to wean from cardiopulmonary bypass following cardiac surgery. Bleeding is one of the most common complications in ECMO patients due to coagulopathy, systemic anticoagulation, and the presence of large bore cannulas at systemic pressure. Absence of a standardized transfusion protocol in this population leads to inconsistent transfusion practices...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28700481/a-multiparameter-model-predicting-in-hospital-mortality-in-malignant-cerebral-infarction
#18
Chien-Fu Chen, Ruey-Tay Lin, Hsiu-Fen Lin, A-Ching Chao
The early identification of patients with large hemisphere infarctions (LHIs) at risk of fatal brain edema may result in better outcomes. A quantitative model using parameters obtained at admission may be a predictor of in-hospital mortality from LHI.This prospective study enrolled all patients with LHI involving >50% of the middle cerebral artery (MCA) admitted to our neurological intensive care unit within 48 hours of symptom onset. Early clinical and radiographic parameters and the baseline CHADS2 score (congestive heart failure, hypertension, age ≥ 75 years, diabetes mellitus, stroke [double weight]) were analyzed regarding their ability to predict patient outcomes...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28700186/-the-treatment-of-aki-in-nephrology-hospitalization-the-sle-hdf-15-litres-in-10-hours
#19
REVIEW
Marcello Napoli, Maria Luisa Lefons, Giovanni Sandri, Efisio Sozzo, Carmela Ambrosino
The AKI in intensive care has been widely treated by international and national guidelines. The treatment of AKI in patients not requiring admission in Intensive Care Unit, but often hospitalized in Nephrology Unit, it is showed of less relevance. For over 5 years we have used for the treatment of AKI of patients admitted in Nephrology Unit an intermittent slow technique, implemented in approximately 600 patients with AKI for a total of about 3000 treatments. In this study we report the clinical results obtained in 100 consecutive patients referred to our Nephrology Unit from 1st January 2014...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28680277/trastuzumab-induced-cardiotoxicity-testing-a-clinical-risk-score-in-a-real-world-cardio-oncology-population
#20
M Rushton, C Johnson, S Dent
BACKGROUND: Trastuzumab has improved survival for women with her2-positive breast cancer, but its use is associated with an increased risk of cardiotoxicity. With increased survivorship, the long-term effects of cancer treatment are an important consideration for clinicians and patients. We reviewed the current literature on predicting trastuzumab-related cardiotoxicity and tested a clinical risk score (crs) in a real-world breast cancer population to assess its utility in predicting permanent cardiotoxicity...
June 2017: Current Oncology
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