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Heart failure intensive care

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https://www.readbyqxmd.com/read/29217447/early-experience-with-fenestrated-endovascular-compared-to-open-repair-of-complex-abdominal-aortic-aneurysms-in-a-high-volume-open-aortic-center
#1
Sarah E Deery, Robert T Lancaster, Anna M Gubala, Thomas F X O'Donnell, Christopher J Kwolek, Mark F Conrad, Richard P Cambria, Virendra I Patel
OBJECTIVE: Early data suggest that FEVAR is feasible but may have higher morbidity and unclear durability compared to open surgical repair (OSR) of complex abdominal aortic aneurysms (CAAA). We compared the early experience following elective FEVAR to traditional OSR of CAAA in a high-volume open aortic center. METHODS: All patients undergoing FEVAR and OSR for elective CAAA from 1/2010-7/2015 were identified. Univariate, multivariable logistic, and Cox hazards modeling were used to compare perioperative and intermediate outcomes...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29216938/-a-model-based-on-random-forests-in-prediction-of-28-day-prognosis-in-patients-with-severe-sepsis-septic-shock
#2
Yang Wang, Shangzhong Chen, Caibao Hu, Changqin Chen, Jing Yan, Guolong Cai
OBJECTIVE: To establish a severe sepsis/septic shock prognosis prediction model based on randomize forest law (RF model), and to evaluate the prognostic value of this model for patients with severe sepsis/septic shock. METHODS: 497 patients with severe sepsis/septic shock admitted to intensive care unit (ICU) of Zhejiang Hospital from September 2013 to May 2017 were enrolled. The basic data, vital signs and symptoms, biochemical indexes and blood routine indexes on the 1st, 3rd, 5th day and prognosis were collected...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#3
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29199512/long-term-renal-and-overall-survival-of-critically-ill-patients-with-acute-renal-injury-who-received-continuous-renal-replacement-therapy
#4
Lingping Wu, Ping Zhang, Yi Yang, Hua Jiang, Yongchun He, Chunping Xu, Huijuan Yan, Qi Guo, Qun Luo, Jianghua Chen
BACKGROUND: Acute kidney injury (AKI) is associated with the increased short-term mortality of critically ill patients on continuous renal replacement therapy (CRRT). The aim of this research was to evaluate the association of kidney function at discharge with the long-term renal and overall survival of critically ill patients with AKI who were on CRRT in an intensive care unit (ICU). METHODS: We retrospectively collected data for critically ill patients with AKI who were admitted to ICU on CRRT at a tertiary metropolitan hospital in China between 2008 and 2013...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/29177463/elevated-potassium-levels-in-patients-with-chronic-kidney-disease-occurrence-risk-factors-and-clinical-outcomes-a-danish-population-based-cohort-study
#5
Reimar W Thomsen, Sia K Nicolaisen, Pål Hasvold, Ricardo Garcia Sanchez, Lars Pedersen, Kasper Adelborg, Kenneth Egstrup, Martin Egfjord, Henrik Toft Sørensen
Background: Data on the true burden of hyperkalemia (HK) in patients with chronic kidney disease (CKD) in a real-world setting are scarce. Methods: The incidence rate of HK [first blood test with an elevated blood potassium level level >5.0 mmol/L] in primary or hospital care was assessed in a population-based cohort of all newly diagnosed CKD patients [second estimated glomerular filtration rate (eGFR) measurement <60 mL/min/1.73 m 2 or hospital diagnosis] in northern Denmark...
November 21, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29174750/assessment-of-pulmonary-edema-principles-and-practice
#6
REVIEW
Sherif Assaad, Wolf B Kratzert, Benjamin Shelley, Malcolm B Friedman, Albert Perrino
Pulmonary edema increasingly is recognized as a perioperative complication affecting outcome. Several risk factors have been identified, including those of cardiogenic origin, such as heart failure or excessive fluid administration, and those related to increased pulmonary capillary permeability secondary to inflammatory mediators. Effective treatment requires prompt diagnosis and early intervention. Consequently, over the past 2 centuries a concentrated effort to develop clinical tools to rapidly diagnose pulmonary edema and track response to treatment has occurred...
August 19, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29173356/contrast-induced-nephropathy-after-cardiac-catheterization-culprits-consequences-and-predictors
#7
Yub Raj Sedhai, Reshma Golamari, Santosh Timalsina, Soney Basnyat, Ajay Koirala, Ankush Asija, Tatvam Choksi, Akanksha Kushwah, David Geovorgyan, Tawseef Dar, Madhura Borikar, Waseem Ahangar, Joseph Alukal, Subtain Zia, Jose Missri
BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication after radiocontrast exposure. METHODS: A retrospective medical record review of 513 hospitalized patients who underwent cardiac catheterization from June-December 2014 was done, of which 38 patients with end-stage renal disease and 57 patients without preprocedural creatinine were excluded. Serum creatinine concentration before the procedure and each day for 3 days after the procedure was recorded...
November 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29169604/validation-of-peripherally-inserted-central-catheter-derived-fick-cardiac-outputs-in-patients-with-heart-failure
#8
Kristen M Tecson, Anupama Vasudevan, Amarinder Bindra, Susan M Joseph, Joost Felius, Shelley A Hall, Parag Kale
The pulmonary artery catheter (PAC) remains the gold standard to calculate Fick cardiac outputs (FCOs) in patients with heart failure admitted to the intensive care unit (ICU). The peripherally inserted central catheter (PICC) provides long-term intravenous access and is used outside the ICU; however, there is scant literature validating venous oxygen saturations (VOSs) from PICC lines. Heart failure patients in the ICU with an existing PAC requiring a PICC line to transition were enrolled. Three blood samples were taken per person (1 at PICC, 1 at central venous pressure [CVP], and 1 at distal PAC)...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29158060/meta-analysis-of-the-outcome-after-postcardiotomy-venoarterial-extracorporeal-membrane-oxygenation-in-adult-patients
#9
Fausto Biancari, Andrea Perrotti, Magnus Dalén, Mariapia Guerrieri, Antonio Fiore, Daniel Reichart, Angelo M Dell'Aquila, Giuseppe Gatti, Tero Ala-Kokko, Eeva-Maija Kinnunen, Tuomas Tauriainen, Sidney Chocron, Juhani K E Airaksinen, Vito G Ruggieri, Debora Brascia
OBJECTIVE: This study was planned to pool existing data on outcome and to evaluate the efficacy of postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adult patients. DESIGN: Systematic review of the literature and meta-analysis. SETTING: Multi-institutional study. PARTICIPANTS: Adult patients with acute heart failure immediately after cardiac surgery. INTERVENTIONS: VA-ECMO after cardiac surgery...
September 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#10
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29136712/-long-term-outcome-and-prognostic-factors-in-pregnant-women-with-pulmonary-arterial-hypertension-associated-with-congenital-heart-disease
#11
Q T Ou, J K Lu, J Zhang, Y Chen, Q Li, J L Zhang
Objective: To investigate the perinatal outcome, risk factors and long-term outcome of pregnancy complicated with pulmonary arterial hypertension(PAH) and congenital heart diseases (CHD). Methods: Clinical data of 110 pregnant women who were diagnosed as PAH-CHD were retrospectively analyzed in the Department of Obstetrics and Gynecology and Surgical Intensive Care Unit at Beijing Anzhen Hospital from 2004 to 2013. The survival and treatment status were followed up. Results: 110 subjects consisted of 11 mild PAH, 33 moderate and 66 severe ones...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29132918/the-first-in-human-experience-with-a-minimally-invasive-ambulatory-counterpulsation-heart-assist-system-for-advanced-congestive-heart-failure
#12
Valluvan Jeevanandam, Tae Song, David Onsager, Takeyoshi Ota, Colleen Juricek LaBuhn, Thomas Lammy, Gabriel Sayer, Gene Kim, Sonna Patel-Raman, Nir Uriel
BACKGROUND: The intravascular ventricular assist system (iVAS) is a new, minimally invasive, ambulatory counterpulsation heart assist system delivered via the subclavian artery and powered by a portable driver. It is designed for recovery, bridge to transplantation (BTT) or for prolonging medical therapy. We report the first-in-human (FIH) experience with iVAS. METHODS: This is a prospective, non-randomized single arm, U.S. Food and Drug Administration (FDA)-approved early feasibility trial in patients listed for cardiac transplantation...
November 10, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29128962/good-response-to-tolvaptan-shortens-hospitalization-in-patients-with-congestive-heart-failure
#13
Tomohito Kogure, Kentaro Jujo, Kazuyuki Hamada, Katsumi Saito, Nobuhisa Hagiwara
Tolvaptan has been gradually spread to use as a potent diuretic for congestive heart failure in the limited country. However, the response to this aquaretic drug still is unpredictable. A total of 92 patients urgently hospitalized due to congestive heart failure and treated with tolvaptan in addition to standard treatment was retrospectively analyzed. Responder of tolvaptan treatment was defined as a patient with peak negative fluid balance greater than 500 mL/day, and clinical profiles were compared between 76 responders and 16 non-responders...
November 11, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29125033/medical-costs-in-patients-with-heart-failure-after-acute-heart-failure-events-one-year-follow-up-study
#14
Eugene Kim, Hye-Young Kwon, Sang Hong Baek, Haeyoung Lee, Byung-Su Yoo, Seok-Min Kang, Youngkeun Ahn, Bongmin Yang
AIMS: This study investigated annual medical costs using real-world data focusing on acute heart failure. METHODS: The data were retrospectively collected from 6 tertiary hospitals in South Korea. Overall, about 330 patients who were hospitalized for acute heart failure between January 2011 and July 2012 were selected. We collected data on their follow-up medical visits for one year, including medical costs incurred toward treatment. Those who died within the observational period or who had no records of follow-up visits were excluded...
November 10, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29124121/patients-comorbidities-reduce-the-clinical-value-of-emergency-colonoscopy-results-of-a-retrospective-cohort-study
#15
Cristiano Cremone, Anouk Esch, Charlotte Gagniere, Alessandro Fugazza, Faria Mesli, Michael Levy, Aurelien Amiot, Alexis Laurent, Yann LeBaleur, Francois Hemery, Nicolas De'Angelis, Francesco Brunetti, Iradj Sobhani
Background and study aims:  Urgent endoscopy is often used to diagnose and sometimes treat acute upper gastrointestinal syndromes (hemorrhage, toxic ingestion, and occlusion). However, its suitability concerning the management of lower gastrointestinal conditions in emergency circumstances is controversial. Patients and methods:  We studied the role of emergency colonoscopy in diagnosis and treatment of all consecutive patients presenting with acute lower gastrointestinal symptoms referred to our hospital on an emergency basis...
November 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/29122513/tako-tsubo-syndrome-in-men-rare-but-with-poor-prognosis
#16
Alberto Pérez-Castellanos, Manuel Martínez-Sellés, Hernán Mejía-Rentería, Mireia Andrés, Alessandro Sionis, Manuel Almendro-Delia, Ana Martín-García, María Cruz Aguilera, Eduardo Pereyra, José A Linares Vicente, Bernardo García de la Villa, Iván J Núñez-Gil
INTRODUCTION AND OBJECTIVES: Tako-tsubo syndrome is a potentially serious disease during the acute phase. It mimics myocardial infarction, but with no potentially causative coronary lesions. The aim of this study was to analyze the clinical course and outcome of patients with tako-tsubo syndrome by sex. METHODS: We analyzed the characteristics of patients included in the RETAKO registry from 2003 to 2015, a multicenter registry with participation of 32 Spanish hospitals...
November 6, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29111110/impact-of-injectable-furosemide-hospital-shortage-on-congestive-heart-failure-outcomes-a-time-series-analysis
#17
MULTICENTER STUDY
Vivian S Tan, Danielle M Nash, Eric McArthur, Arsh K Jain, Amit X Garg, David N Juurlink, Matthew A Weir
BACKGROUND: Beginning in February 2012, there was a shortage of injectable furosemide in the province of Ontario, Canada. The objective of this study was to assess the effects of the furosemide shortage on heart failure outcomes in Ontario, Canada. METHODS: We determined which hospitals experienced a shortage of injectable furosemide using an online survey. We then used health administrative data to identify all patients who presented to those hospitals with congestive heart failure...
November 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29104480/heart-failure-and-mortality-of-adult-survivors-from-acute-myocarditis-requiring-intensive-care-treatment-a-nationwide-cohort-study
#18
Jung-Jung Chang, Ming-Shyan Lin, Tien-Hsing Chen, Dong-Yi Chen, Shao-Wei Chen, Jen-Te Hsu, Po-Chang Wang, Yu-Sheng Lin
Background The correlation between severity and long-term outcomes of pediatric myocarditis have been reported, however this correlation in adults has rarely been studied. Materials and Methods This nationwide population-based cohort study used data from the National Health Insurance Research Database in Taiwan. Patients aged < 75 and > 18 years admitted to an intensive care unit due to acute myocarditis were enrolled and divided into three groups according to mechanical circulatory support (MCS) after excluding major comorbidities...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29074117/intensive-care-unit-admission-after-endovascular-aortic-aneurysm-repair-is-primarily-determined-by-hospital-factors-adds-significant-cost-and-is-often-unnecessary
#19
Caitlin W Hicks, Husain N Alshaikh, Devin Zarkowsky, Ian C Bostock, Besma Nejim, Mahmoud B Malas
BACKGROUND: A large proportion of endovascular aortic aneurysm repair (EVAR) patients are routinely admitted to the intensive care unit (ICU) for postoperative observation. In this study, we aimed to describe the factors associated with ICU admission after EVAR and to compare the outcomes and costs associated with ICU vs non-ICU observation. METHODS: All patients undergoing elective infrarenal EVAR in the Premier database (2009-2015) were included. Patients were stratified as ICU vs non-ICU admission according to location on postoperative day 0...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29062561/transposition-of-the-great-arteries-and-coarctation-of-the-aorta-in-an-infant-presenting-with-bronchiolitis-an-incidental-finding
#20
Khaloud S Al-Mukhaini, Ala M Mohamed
The transposition of the great arteries (TGA) is a complex congenital heart disease which usually presents as cyanosis in neonates with limited mixing between the systemic and pulmonary circulatory systems. A delayed diagnosis of TGA can lead to ventricular failure. We report a six-week-old infant who was admitted to the paediatric Intensive Care Unit of the Royal Hospital, Muscat, Oman, in 2016 for bronchiolitis. During admission, she was incidentally diagnosed with TGA and coarctation of the aorta. Postnatal screening, including the use of pulse oximetry, plays a significant role in avoiding a late diagnosis of TGA; however, this screening tool is not widely used in Oman...
August 2017: Sultan Qaboos University Medical Journal
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