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https://www.readbyqxmd.com/read/28930917/shock-2017-military-supplement-an-overview-of-two-human-trials-of-perfluorocarbon-emulsions-in-non-cardiac-surgery
#1
Donat R Spahn, Peter E Keipert
Perfluorochemicals (PFCs) constitute one class of artificial oxygen carriers that are being produced completely synthetically. One formulation that has been evaluated extensively in clinical trials is a 60% w/v perflubron-based emulsion. Efficacy and safety of this perflubron emulsion was evaluated in a Phase 2 and a large prospective randomized Phase 3 multicenter European study, which collectively included a total of 639 patients. Perflubron emulsion was highly successful in improving organ function, reversing physiologic transfusion triggers and in reducing the need for allogeneic blood transfusions...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28927169/c-reactive-protein-level-on-admission-and-time-to-and-cause-of-death-in-patients-hospitalized-for-acute-heart-failure
#2
Yuichiro Minami, Katsuya Kajimoto, Naoki Sato, Nobuhisa Hagiwara, Teruo Takano
Aims: We analysed the association between C-reactive protein (CRP) levels measured on admission and timing and cause of death among patients hospitalized for acute heart failure (AHF). Methods and Results: The ATTEND study prospectively registered 4777 hospitalized AHF patients with data on CRP levels on admission. Mortality risks were assessed by univariable and multivariable Cox proportional and non-proportional hazards models. The overall median CRP level was 5...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28926873/-to-enhance-clinical-application-of-comprehensive-geriatric-assessment-in-elderly-inpatients-with-non-cardiac-surgical-operation
#3
X M Wang, Y Liu
In this commentary article, we introduce the definition, evaluative contents and methods of comprehensive geriatric assessment (CGA), as well as its successful application in Western countries. CGA is a multidisciplinary diagnosis and treatment process that identifies medical, psychosocial, and functional capabilities of elderly adults to develop plans including overall treatment, nursing, and follow-up to maximize overall health with aging. How to change this situation has become an important challenge due to the significant increase in postoperative complications, mortality, and treatment costs for elderly patients with surgical diseases...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28917560/outcomes-of-rescue-cardiopulmonary-support-for-periprocedural-acute-hemodynamic-decompensation-in-patients-undergoing-catheter-ablation-of-electrical-storm
#4
Andres Enriquez, Jackson Liang, Javier Gentile, Robert Schaller, Gregory Supple, David S Frankel, Fermin Garcia, Joyce Wald, Edo Y Birati, J Eduardo Rame, Christian Bermudez, David Callans, Francis Marchlinski, Pasquale Santangeli
BACKGROUND: In patients with ventricular tachycardia/fibrillation (VT/VF) electrical storm (ES) undergoing catheter ablation (CA), hypotension due to refractory VT/VF, use of anesthesia and cardiac stunning due to repeated ICD shocks might precipitate acute hemodynamic decompensation (AHD). OBJECTIVE: We evaluated the outcomes of emergent cardiopulmonary support with extracorporeal membrane oxygenation (ECMO) to rescue AHD in patients undergoing CA of ES. METHODS: Between 2010 and 2016, 21 patients with ES (VT in 11 and PVC-triggered VF in 10) were referred for CA and had periprocedural AHD requiring emergent ECMO support...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28917160/is-magnet%C3%A2-recognition-associated-with-improved-outcomes-among-critically-ill-children-treated-at-freestanding-children-s-hospitals
#5
Mallikarjuna Rettiganti, Kavisha M Shah, Jeffrey M Gossett, Joshua A Daily, Paul M Seib, Punkaj Gupta
PURPOSE: With increasing emphasis on high-quality care, we designed this study to evaluate the relationship between Magnet® recognition and patient outcomes in pediatric critical care. MATERIALS AND METHODS: Post hoc analysis of data from an existing administrative national database. We used inverse probability of treatment weighting and multivariate models to compare outcomes between two study groups after adjusting for confounding variables. RESULTS: A total of 823,634 pediatric patients from 41 centers were included...
September 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28912198/frequency-of-low-value-care-in-alberta-canada-a-retrospective-cohort-study
#6
Finlay A McAlister, Meng Lin, Jeff Bakal, Stafford Dean
OBJECTIVE: To determine how frequently 10 low-value services highlighted by Choosing Wisely are done and what factors influence their provision. METHODS: This is a retrospective cohort study using routinely collected health data from five linked data sets from 2012 to 2015 in the Canadian province of Alberta to determine the frequency with which 10 low-value services were provided. RESULTS: Between 2012 and 2015, 162 143 people (4% of all 3 814 536 adult Albertans and 5% of the 3 423 135 who saw a physician at least once in that time frame) received at least one of the 10 low-value services, including 29...
September 14, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28911292/a-retrospective-observational-study-of-patients-with-dilated-cardiomyopathy-undergoing-non-cardiac-surgery
#7
K A Cook, P A MacIntyre, J R McAlpine
The perioperative risks and factors associated with adverse cardiac outcomes in patients with dilated cardiomyopathy undergoing non-cardiac surgery are unknown. Interrogation of the Nelson Hospital transthoracic echocardiogram database identified 127 patients with dilated cardiomyopathy who satisfied the study criteria and underwent non-cardiac surgery between June 1999 and July 2013. Demographic and clinical data along with postoperative death within 30 days or a major adverse cardiac event were retrieved and analysed...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#8
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28890557/are-cardiac-surgical-patients-at-increased-risk-of-difficult-intubation
#9
Deepak Prakash Borde, Savani Sameer Futane, Vijay Daunde, Sujata Zine, Nayana Joshi, Sumit Jaiswal, Sadhana Chinchole, Prasannakumar Kulkarni, Amit Hiwarkar, Priti Bhagyawant, Dilip Deshmukh, Manisha Takalkar
BACKGROUND AND AIMS: Safe airway management is the cornerstone of contemporary anaesthesia practice, and difficult intubation (DI) remains a major cause of anaesthetic morbidity and mortality. The surgical category, particularly cardiac surgery as a risk factor for DI has not been studied extensively. The aim of this study was to test the hypothesis whether cardiac surgical patients are at increased risk of DI. METHODS: During the study, 627 patients (329 cardiac and 298 non-cardiac surgical) were enrolled...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28889824/differences-in-clinical-outcomes-and-cost-between-complex-and-simple-arterial-switches
#10
Eric R Griffiths, Nelangi M Pinto, Aaron W Eckhauser, Ragheed Al-Dulaimi, Angela P Presson, David K Bailly, Phillip T Burch
BACKGROUND: This study evaluates the morbidity, mortality, and cost differences between patients who underwent either a simple or a complex arterial switch operation. METHODS: A retrospective study of patients undergoing an arterial switch operation at a single institution was performed. Simple cases were defined as patients with d-transposition of the great arteries with usual coronary anatomy or circumflex artery originating from the right with either intact ventricular septum or ventricular septal defect...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28888555/functional-impairment-prior-to-major-non-cardiac-surgery-is-associated-with-mortality-within-one-year-in-elderly-patients-with-gastrointestinal-gynaecological-and-urogenital-cancer-a-prospective-observational-cohort-study
#11
Maren Schmidt, Rahel Eckardt, Sarah Altmeppen, Klaus-Dieter Wernecke, Claudia Spies
OBJECTIVE: To investigate the prognostic value of elements of the Geriatric Assessment, in particular the Timed Up and Go (TUG) Test and the Barthel Index of Activities of Daily Living (ADL) for one-year post-operative mortality in elderly patients with cancer. MATERIALS AND METHODS: This prospective cohort study included patients 65years of age or older undergoing elective major surgery for cancer between June 2008 and June 2010. Preoperative functional status was measured by the TUG Test and the Barthel Index of ADL Cognitive state was assessed by the Mini Mental State Examination (MMSE)...
September 6, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28884341/-current-strategies-in-the-treatment-of-ventricular-tachycardia-by-catheter-ablation-a%C3%A2-review
#12
REVIEW
S Koenig, A Arya, G Hindricks, B Dinov
The treatment of ventricular tachycardia has recently undergone relevant changes as certain interventional treatment options, such as radiofrequency catheter ablation, have gained in importance. Numerous current publications have demonstrated the advantages of catheter ablation compared to conventional therapy with antiarrhythmic drugs in terms of effectiveness and morbidity. Improving the ablation technique and identifying those patient collectives who are most likely to benefit from ablation are still the objectives of current research...
September 7, 2017: Herz
https://www.readbyqxmd.com/read/28874283/mortality-in-adults-with-congenital-heart-disease
#13
Pavithra Naidu, Leeanne Grigg, Dominica Zentner
AIM: Retrospective ascertainment of the causes of mortality in the adult congenital heart disease (ACHD) cohort of the Royal Melbourne Hospital (RMH). METHODS: Deceased patients (n=73) of the 2519 ACHD patients in the Royal Melbourne Hospital registry (commenced in 1991) were identified. Retrospective analysis was undertaken. Age, gender of deceased individuals, and frequency and cause of death in different congenital diagnosis groups was explored. RESULTS: Between 1991 and 2015, death occurred in 3...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28870611/safety-and-activity-of-microrna-loaded-minicells-in-patients-with-recurrent-malignant-pleural-mesothelioma-a-first-in-man-phase-1-open-label-dose-escalation-study
#14
Nico van Zandwijk, Nick Pavlakis, Steven C Kao, Anthony Linton, Michael J Boyer, Stephen Clarke, Yennie Huynh, Agata Chrzanowska, Michael J Fulham, Dale L Bailey, Wendy A Cooper, Leonard Kritharides, Lloyd Ridley, Scott T Pattison, Jennifer MacDiarmid, Himanshu Brahmbhatt, Glen Reid
BACKGROUND: TargomiRs are minicells (EnGeneIC Dream Vectors) loaded with miR-16-based mimic microRNA (miRNA) and targeted to EGFR that are designed to counteract the loss of the miR-15 and miR-16 family miRNAs, which is associated with unsuppressed tumour growth in preclinical models of malignant pleural mesothelioma. We aimed to assess the safety, optimal dosing, and activity of TargomiRs in patients with malignant pleural mesothelioma. METHODS: In this first-in-man, open-label, dose-escalation phase 1 trial at three major cancer centres in Sydney (NSW, Australia), we recruited adults (aged ≥18 years) with a confirmed diagnosis of malignant pleural mesothelioma, measurable disease, radiological signs of progression after previous chemotherapy, Eastern Cooperative Oncology Group performance status of 0 or 1, life expectancy of 3 months or more, immunohistochemical evidence of tumour EGFR expression, and adequate bone marrow, liver, and renal function...
September 1, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28868079/two-case-of-preoperative-bridging-therapy-for-patients-undergoing-non-cardiac-surgery-after-coronary-stent-implantation
#15
Le-Qun Zhou, Shao-Min Chen, Yong-Zhen Zhang, Li-Yun He, Wei Gao
No abstract text is available yet for this article.
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28862284/detection-of-atrial-fibrillation-in-patients-with-embolic-stroke-of-undetermined-source-by-prolonged-monitoring-with-implantable-loop-recorders
#16
Carsten Israel, Alkisti Kitsiou, Malik Kalyani, Sameera Deelawar, Lucy Ekosso Ejangue, Andreas Rogalewski, Christoph Hagemeister, Jens Minnerup, Wolf-Rüdiger Schäbitz
Recently, the clinical entity embolic stroke of undetermined source (ESUS) has been defined for patients with ischemic strokes, where neither a cardioembolic nor a non-cardiac source can be detected. These patients may suffer from asymptomatic atrial fibrillation (AF), terminating spontaneously and thus eluding detection. Implantable loop recorders (ILR) with automatic AF detection algorithms can detect short-lasting, subclinical AF. The aim of this study was to prospectively assess and predict AF detection in patients with ESUS using ILR with daily remote interrogation...
September 1, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28859124/effect-of-general-anesthesia-on-neonatal-aeeg-a-cohort-study-of-patients-with-non-cardiac-congenital-anomalies
#17
Lisanne J Stolwijk, Lauren C Weeke, Linda S de Vries, Maud Y A van Herwaarden, David C van der Zee, Desiree B M van der Werff, Manon J N L Benders, Mona Toet, Petra M A Lemmers
INTRODUCTION: The aim of the current study was to determine the effect of general anesthesia on neonatal brain activity using amplitude-integrated EEG (aEEG). METHODS: A prospective cohort study of neonates (January 2013-December 2015), who underwent major neonatal surgery for non-cardiac congenital anomalies. Anesthesia was administered at the discretion of the anesthetist. aEEG monitoring was started six hours preoperatively until 24 hours after surgery. Analysis of classes of aEEG background patterns, ranging from continuous normal voltage to flat trace in six classes, and quantitative EEG-measures, using spontaneous activity transients (SATs) and interSATintervals (ISI), was performed...
2017: PloS One
https://www.readbyqxmd.com/read/28854537/prognostic-significance-of-central-venous-to-arterial-carbon-dioxide-difference-during-the-first-24-hours-of-septic-shock-in-patients-with-and-without-impaired-cardiac-function
#18
G Muller, E Mercier, P Vignon, M Henry-Lagarrigue, T Kamel, A Desachy, V Botoc, G Plantefève, J P Frat, F Bellec, J P Quenot, P F Dequin, T Boulain
Objective: To investigate the prognostic significance of central venous-to-arterial carbon dioxide difference (cv-art CO 2 gap) during septic shock in patients with and without impaired cardiac function. Methods: We performed a prospective cohort study in 10 French intensive care units. Patients suffering from septic shock were assigned to the impaired cardiac function group ('cardiac group', n =123) if they had atrial fibrillation (AF) and/or left ventricular ejection fraction (LVEF) <50% at study entry and to the non-cardiac group ( n =240) otherwise...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28852817/risk-factors-for-heart-failure-and-its-costs-among-children-with-complex-congenital-heart-disease-in-a-medicaid-cohort
#19
Deipanjan Nandi, Joseph W Rossano, Yinding Wang, Jeanette M Jerrell
Little research attention has been paid to the occurrence of heart failure (HF) in children with complex congenital heart diseases (CHDs). Herein, we describe the prevalence, risk factors, and costs associated with HF in complex CHD. Patients aged ≤17 years and diagnosed with a complex CHD on multiple service visits over a 15-year period in the SC Medicaid dataset (1996-2010) were tracked and analyzed. The cohort included 2999 unduplicated patients; 51.0% were male; 34.4% were African American. HF was diagnosed in 7...
August 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28851605/new-onset-atrial-fibrillation-and-clinical-outcome-in-non-cardiac-intensive-care-unit-patients
#20
Stamatis S Makrygiannis, Despina Rizikou, Nikolaos G Patsourakos, Manolis Lampakis, Anastasia Margariti, Olga S Ampartzidou, Konstantinos Sakellaridis, Paraskevi Tselioti, Athanasios Pipilis, Athanasios A Prekates
BACKGROUND: Data regarding new onset atrial fibrillation (nAF) in general, non-cardiac, intensive care unit (ICU) patients are limited. However, it has been suggested that nAF is associated with worse clinical outcome in these patients. OBJECTIVE: The purpose of the present work was to study the prognostic impact of nAF, in this setting. METHODS: We prospectively studied all patients admitted to a single ICU for a period of 12 months. Patients admitted for brief post-operative monitoring, patients with chronic, intermittent atrial fibrillation and atrial fibrillation present upon admission, were excluded...
August 26, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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