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Heart failure intensive care

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https://www.readbyqxmd.com/read/29455380/clinical-features-and-peripartum-outcomes-in-pregnant-women-with-cardiac-disease-a-nationwide-retrospective-cohort-study-in-japan
#1
Toshiaki Isogai, Hiroki Matsui, Hiroyuki Tanaka, Akira Kohyama, Kiyohide Fushimi, Hideo Yasunaga
Although the number of pregnancies in women with cardiac disease is increasing worldwide, there are few data concerning their clinical characteristics and peripartum outcomes. Using the Diagnosis Procedure Combination database between 2008 and 2014 in Japan, we retrospectively identified pregnant women who underwent high-risk delivery due to obstetric or non-obstetric comorbidities. We classified eligible women into those with pre-existing cardiac disease (cardiac disease group) and those with non-cardiac comorbidities (non-cardiac disease group) and compared their characteristics and peripartum outcomes...
February 17, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29455034/preoperative-risk-factors-for-unexpected-postoperative-intensive-care-unit-admission-a-retrospective-case-analysis
#2
Joshua B Knight, Evan E Lebovitz, Theresa A Gelzinis, Ibtesam A Hilmi
INTRODUCTION: The purpose of this retrospective case-control study was to investigate preoperative risk factors for unexpected postoperative intensive care unit (ICU) admissions in patients undergoing non-emergent surgical procedures in a tertiary medical centre. METHODS: A medical record review of adult patients undergoing elective non-cardiac and non-transplant major surgical procedures during the period of January 2011 through December 2015 in the operating rooms of a large university hospital was carried out...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29451101/severe-tricuspid-regurgitation-and-seizure-on-postpartum-day-10-case-report-of-late-postpartum-eclampsia
#3
Martin Vanden Eede, Matthew Schroyens
OBJECTIVE AND IMPORTANCE: Late postpartum eclampsia is characterized by pre-eclampsia and tonic-clonic seizures presenting more than 48 hours postpartum. It is a rare, frightening and dangerous complication that requires rapid recognition and adequate treatment. CLINICAL PRESENTATION: We present a case of late postpartum eclampsia, initially diagnosed as right-sided heart failure, 10 days postpartum.Two days after the delivery she developed mild swelling of both feet, progressive shortness of breath on exertion and orthopnea...
February 16, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29434130/a-case-of-quetiapine-related-acute-kidney-injury-requiring-transient-continuous-hemodiafiltration
#4
Haruhi Yamada, Yukiko Katsumori, Miki Kawano, Shumpei Mori, Ryo Takeshige, Jun Mukai, Hiroshi Imada, Hiroyuki Shimoura, Hachidai Takahashi, Tadasu Horai, Yutaka Okita, Ken-Ichi Hirata
A 73-year-old man, with congestive heart failure due to combined valvar disease, underwent curative surgery. Although the surgery was successful, his clinical course was eventful because of pulmonary complications, and he began to deteriorate mentally. Quetiapine was prescribed, which appeared to effectively settle his mental status. Following the administration of quetiapine, however, he developed acute kidney injury (AKI) that required continuous hemodiafiltration. Subsequent to discontinuation of quetiapine, his renal function gradually improved...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29417223/relationship-between-blood-urea-nitrogen-to-creatinine-ratio-at-hospital-admission-and-long-term-mortality-in-patients-with-acute-decompensated-heart-failure
#5
Azusa Murata, Takatoshi Kasai, Yuya Matsue, Hiroki Matsumoto, Shoichiro Yatsu, Takao Kato, Shoko Suda, Masaru Hiki, Atsutoshi Takagi, Hiroyuki Daida
Although elevated blood urea nitrogen (BUN)-to-creatinine (BUN/Cr) ratio at hospital admission has been reported to be associated with poor short-term prognosis, its association to long-term mortality in patients with acute decompensated heart failure (ADHF) remains to be elucidated. Moreover, an additive prognostic value to preexisting renal markers including creatinine and BUN has not been well described. A cohort of 557 consecutive ADHF patients admitted to the cardiac intensive care unit was studied. All cohorts were divided into high and low BUN/Cr ratios according to the median value of BUN/Cr ratio at admission...
February 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29412764/will-changes-to-medicare-payment-rates-alter-hospice-s-cost-saving-ability
#6
Donald H Taylor, Nrupen A Bhavsar, Janet H Bull, Cordt T Kassner, Andrew Olson, Nathan A Boucher
BACKGROUND: On January 1, 2016, Medicare implemented a new "two-tiered" model for hospice services, with per diem rates increased for days 1 through 60, decreased for days 61 and greater, and service intensity add-on payments made retrospectively for the last seven days of life. OBJECTIVE: To estimate whether the Medicare hospice benefit's potential for cost savings will change as a result of the January 2016 change in payment structure. DESIGN: Analysis of decedents' claims records using propensity score matching, logistic regression, and sensitivity analysis...
February 7, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29407093/evolution-of-natriuretic-peptide-biomarkers-in-heart-failure-implications-for-clinical-care-and-clinical-trials
#7
Nicolas Vodovar, Alexandre Mebazaa, James L Januzzi, Gillian Murtagh, Wendy Gattis Stough, Kirkwood F Adams, Faiez Zannad
Natriuretic peptides (NPs) are recommended by international guidelines to exclude non-heart failure causes of acute dyspnea and to assess prognosis. NPs are commonly used as an entry criterion for clinical trials, to minimize enrollment of misdiagnosed patients, or to ensure enrollment of a sufficiently at-risk population. NP values used to select trial populations to date have been inconsistent across studies. Future trials should consider using standardized thresholds for NP levels, with protocol-specified adaptations appropriate for the specific study and patient population to account for factors that can influence the NP level...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29403316/validation-of-modified-world-health-organization-classification-for-pregnant-women-with-heart-disease-in-a-tertiary-care-center-in-southern-thailand
#8
Chitkasaem Suwanrath, Putthaporn Thongphanang, Sutham Pinjaroen, Saranyou Suwanugsorn
Purpose: To validate the modified World Health Organization (WHO) classification in pregnant women with congenital and acquired heart diseases. Patients and methods: The database of pregnant women with heart disease, who delivered at Songklanagarind Hospital between January 1995 and December 2016, was retrieved from the Statistical Unit, Department of Obstetrics and Gynecology, along with the Hospital Information System of Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29402366/-diagnostic-value-of-lung-ultrasound-b-line-score-in-acute-heart-failure
#9
Yan Zhuang, Linfeng Dai, Mingqi Chen, Ning Chang, Jiandong Chen, Haibo Shi
OBJECTIVE: To investigate the value of bedside lung ultrasound B-line score in the diagnosis of acute heart failure (AHF). METHODS: A retrospectively analysis was conducted. The adult patients presenting with acute dyspnea in intensive care unit (ICU) of Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from January 2016 to June 2017 were enrolled. An 8-zone lung ultrasound was performed and plasma B-type natriuretic peptide (BNP) level was tested in all patients...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29402263/effect-of-the-2015-earthquake-on-pediatric-inpatient-pattern-at-a-tertiary-care-hospital-in-nepal
#10
Bishnu Rath Giri, Ram Hari Chapagain, Samana Sharma, Sandeep Shrestha, Sunita Ghimire, P Ravi Shankar
BACKGROUND: Earthquakes impact child health in many ways. Diseases occurring immediately following an earthquake have been studied in field based hospitals but studies on the inpatient disease pattern among children without trauma in a permanent hospital setup is lacking. METHODS: We examined the diagnoses of all children without trauma, admitted to Kanti Children's Hospital, Kathmandu for fifteen-week duration (from 4th week to end of the 18th week) following the 7...
February 5, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29395891/hemodynamic-support-of-a-15-year-old-waiting-for-a-heart-transplant-is-there-a-role-for-levosimendan-in-pediatric-heart-failure
#11
I Goyer, D Brossier, B Toledano
Decompensated heart failure in children requires rapid and aggressive support. In refractory cases, invasive supportive care is essential to ensure cardiac output. This results in lengthy pediatric intensive care unit (PICU) stays, secondary morbidity, and high cost. Levosimendan may help palliate the pitfalls encountered with the usual treatment. It has been shown to improve hemodynamics and decrease morbidity and mortality from heart failure in adult trials and pediatric cohorts. We report the case of a 15-year-old boy with dilated cardiomyopathy and refractory ventricular dysfunction who was weaned from continuous inotropes and discharged from the PICU with levosimendan while waiting for heart transplantation...
January 26, 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29384319/refeeding-hypophosphataemia-after-enteral-nutrition-in-a-malaysian-intensive-care-unit-risk-factors-and-outcome
#12
Azrina Md Ralib, Mohd Basri Mat Nor
BACKGROUND AND OBJECTIVES: Refeeding hypophosphataemia (RH) is characterized by an acute electrolyte derangement following nutrition therapy. Complications associated include heart failure, respiratory failure, paraesthesia, seizure and death. We aim to assess its incidence, risk factors, and outcome in our local intensive care unit (ICU). METHODS AND STUDY DESIGN: A prospective observational cohort study was conducted at the mixed medical- surgical of a tertiary ICU in Kuantan, Malaysia...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29375113/various-cardiac-abnormalities-caused-by-bacterial-myocarditis
#13
Jin Komuro, Kazutaka Ueda, Mitsunobu Kaneko, Shuya Nitta, Masashi Kasao, Munehiro Yokoyama
A 69-year-old woman without any past disease history was hospitalized for heart failure. After hospitalization, she showed myocardial infarction, atrioventricular dissociation, and cardiac dysfunction, and finally she passed away despite intensive care. Autopsy revealed that the cardiac abnormalities were due to bacterial myocarditis possibly resulting from urinary tract infection by E. coli. Although bacterial myocarditis is rare in developed countries, we should consider its possibility when patients show various cardiac abnormalities with bacterial infection...
2018: International Heart Journal
https://www.readbyqxmd.com/read/29375010/aggressive-systolic-blood-pressure-control-in-older-subjects-benefits-and-risks
#14
Steven G Chrysant
Systolic hypertension, especially isolated systolic hypertension (ISH) is very common in older subjects aged ≥ 65 years and is a major risk factor for cardiovascular disease (CVD), strokes, heart failure (HF) and chronic kidney disease (CKD). It is also, directly and linearly related with these complications irrespective of sex, or ethnicity, but it is worse with the advancement of age. Effective control of systolic blood pressure (SBP), is associated with significant reduction in the incidence of these complications...
February 1, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29370259/blood-urea-nitrogen-bun-is-independently-associated-with-mortality-in-critically-ill-patients-admitted-to-icu
#15
Okan Arihan, Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Alexander Lauten, Paul Christian Schulze, Uta C Hoppe, Malte Kelm, Christian Jung
PURPOSE: Blood urea nitrogen (BUN) was reported to be associated with mortality in heart failure patients. We aimed to evaluate admission BUN concentration in a heterogeneous critically ill patient collective admitted to an intensive care unit (ICU) for prognostic relevance. METHODS: A total of 4176 medical patients (67±13 years) admitted to a German ICU between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013...
2018: PloS One
https://www.readbyqxmd.com/read/29368192/cirrhotic-cardiomyopathy-is-less-prevalent-in-patients-with-budd-chiari-syndrome-than-cirrhosis-of-liver
#16
Akash Shukla, Pratin Bhatt, Deepak Kumar Gupta, Tejas Modi, Jatin Patel, Milind Phadke, Krantikumar Rathod, Megha Meshram, S J Bhatia
BACKGROUND AND AIM: Cirrhotic cardiomyopathy (CCM) is associated with high mortality after transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation in patients with cirrhosis. There is no data about the prevalence or impact of CCM in Budd-Chiari syndrome (BCS). We assessed the prevalence of CCM in patients with BCS and its impact on outcome after radiological intervention. METHODS: Thirty-three consecutive patients with BCS (15 men) and 33 controls with hepatitis B-related cirrhosis (18 men, matched for Child-Pugh score) were evaluated with baseline electrocardiography (ECG), echocardiography (ECHO) and dobutamine stress ECHO, and ECG (DSE)...
January 24, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29355173/paradigms-of-acute-kidney-injury-in-the-intensive-care-setting
#17
REVIEW
John A Kellum, John R Prowle
Acute kidney injury (AKI) is a heterogeneous clinical syndrome that has multiple aetiologies, variable pathogenesis and diverse outcomes. However, these heterogeneities are not reflected in current approaches to the diagnosis and, to some degree, treatment of AKI. For example, congestive heart failure and dehydration can produce identical changes in serum creatinine level and urine output (parameters that are used to define AKI); however, they differ vastly in their physiological contexts and demand completely opposite treatments...
January 22, 2018: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29351897/transitions-between-circulatory-states-after-out-of-hospital-cardiac-arrest-protocol-for-an-observational-prospective-cohort-study
#18
Halvor Langeland, Daniel Bergum, Magnus Løberg, Knut Bjørnstad, Jan Kristian Damås, Tom Eirik Mollnes, Nils-Kristian Skjærvold, Pål Klepstad
BACKGROUND: The post cardiac arrest syndrome (PCAS) is responsible for the majority of in-hospital deaths following cardiac arrest (CA). The major elements of PCAS are anoxic brain injury and circulatory failure. OBJECTIVE: This study aimed to investigate the clinical characteristics of circulatory failure and inflammatory responses after out-of-hospital cardiac arrest (OHCA) and to identify patterns of circulatory and inflammatory responses, which may predict circulatory deterioration in PCAS...
January 19, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29339686/clinical-characteristics-and-outcomes-of-acute-coronary-syndrome-patients-with-intra-aortic-balloon-pump-inserted-in-intensive-cardiac-care-unit-of-a-tertiary-clinic
#19
Mert İlker Hayıroğlu, Yiğit Çanga, Özlem Yıldırımtürk, Emrah Bozbeyoğlu, Ayça Gümüşdağ, Ahmet Okan Uzun, Koray Kalenderoğlu, Muhammed Keskin, Göksel Çinier, Murat Acarel, Seçkin Pehlivanoğlu
OBJECTIVE: An intra-aortic balloon pump (IABP) is a mechanical support device that is used in addition to pharmacological treatment of the failing heart in intensive cardiac care unit (ICCU) patients. In the literature, there are limited data regarding the clinical characteristics and in-hospital outcomes of acute coronary syndrome patients in Turkey who had an IABP inserted during their ICCU stay. This study is an analysis of the clinical characteristics and outcomes of these acute coronary syndrome patients...
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29338996/incidence-and-predictors-of-postoperative-need-for-high-dose-inotropic-support-in-patients-undergoing-cardiac-surgery-for-infective-endocarditis
#20
Alessandro Belletti, Stephan Jacobs, Giovanni Affronti, Alexander Mladenow, Giovanni Landoni, Volkmar Falk, Felix Schoenrath
OBJECTIVE: Patients with infective endocarditis undergoing cardiac surgery are a high-risk population. Few data on incidence and predictors of need for high-dose inotropic support in this setting are currently available. DESIGN: Retrospective study. SETTING: Tertiary-care hospital. PARTICIPANTS: Ninety consecutive patients undergoing cardiac surgery for infective endocarditis. INTERVENTIONS: None...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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