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Cardiac intensive care

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https://www.readbyqxmd.com/read/27922256/statins-in-critical-care-to-give-or-not-to-give
#1
Amr S Omar, Samy Hanoura, Haifa M Aljanubi, Ahmed Mahfouz
Owing to statin's immune modulatory, anti-inflammatory, antioxidant, antithrombotic and endothelial function actions, they are widely used in the critical care settings in diverse disease scenarios. We aim to explore the evidence to globalize the utilization of statins in the intensive care practice for different indications. We carried out a search of the PubMed, Cochrane and EMBASE databases up to January 2016. We included review articles, meta-analyses, and original trials on the effects of statin therapy in the intensive care unit (ICU) combining the following MESH terms: 'satins', 'intensive care, 'cardiac surgery', 'sepsis', 'acute respiratory distress syndrome' 'pneumonia', subarachnoid hemorrhage', traumatic brain injury and 'critical illness'...
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#2
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27919715/perioperative-brain-natriuretic-peptide-in-pediatric-cardiac-surgery-patients-its-association-with-postoperative-outcomes
#3
Tomoyuki Kanazawa, Moritoki Egi, Yuichiro Toda, Kazuyoshi Shimizu, Kentaro Sugimoto, Tatsuo Iwasaki, Hiroshi Morimatsu
OBJECTIVES: The aim of this study was to investigate the relationship between perioperative brain natriuretic peptide levels and the incidence of postoperative serious adverse events (SAEs) in pediatric cardiac patients. DESIGN: A prospective observational study. SETTING: A single-institution university hospital. PARTICIPANTS: Children under 15 years old who underwent cardiac surgery that required cardiopulmonary bypass from December 21, 2012 to February 26, 2014...
September 13, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#4
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27918254/clinical-implications-of-mycobacterium-chimaera-detection-in-thermoregulatory-devices-used-for-extracorporeal-membrane-oxygenation-ecmo-germany-2015-to-2016
#5
Franziska C Trudzinski, Uwe Schlotthauer, Annegret Kamp, Kai Hennemann, Ralf M Muellenbach, Udo Reischl, Barbara Gärtner, Heinrike Wilkens, Robert Bals, Mathias Herrmann, Philipp M Lepper, Sören L Becker
Mycobacterium chimaera, a non-tuberculous mycobacterium, was recently identified as causative agent of deep-seated infections in patients who had previously undergone open-chest cardiac surgery. Outbreak investigations suggested an aerosol-borne pathogen transmission originating from water contained in heater-cooler units (HCUs) used during cardiac surgery. Similar thermoregulatory devices are used for extracorporeal membrane oxygenation (ECMO) and M. chimaera might also be detectable in ECMO treatment settings...
November 17, 2016: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#6
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27917566/perioperative-hypothermia-in-neonatal-intensive-care-unit-patients-effectiveness-of-a-thermoregulation-intervention-and-associated-risk-factors
#7
Branden M Engorn, Stephanie L Kahntroff, Karen M Frank, Sarabdeep Singh, Helen A Harvey, Charles T Barkulis, Annika M Barnett, Olamide O Olambiwonnu, Eugenie S Heitmiller, Robert S Greenberg
BACKGROUND: Hypothermia in neonatal intensive care unit patients is associated with morbidity. Perioperative normothermia is the standard of care. AIMS: We hypothesized that a quality improvement intervention (transport protocol, transport education, ongoing monitoring) would decrease the incidence of perioperative hypothermia. Secondarily, we hypothesized that patients undergoing surgery at a postmenstrual age of <37 weeks or at a weight of <1.5 kg would be at higher risk for perioperative hypothermia...
December 5, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27917264/systemic-to-pulmonary-artery-pressure-ratio-as-a-predictor-of-patient-outcome-following-liver-transplantation
#8
Annette Rebel, Dung Nguyen, Brooke Bauer, Paul A Sloan, Amy DiLorenzo, Zaki-Udin Hassan
AIM: To assess the value of the mean systemic-to-pulmonary artery pressure (MAP/mPAP) ratio for predicting outcomes following orthotopic liver transplant (OLT). METHODS: A retrospective data analysis was performed and data (mean arterial blood pressure, mean pulmonary artery pressure and Cardiac Index) were collected at several points during OLT. Outcomes evaluated were duration of postoperative endotracheal intubation [ET; minutes after intensive care unit (ICU) arrival], length of ICU stay, total hospitalization and frequency of immediate postoperative complications...
November 18, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#9
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27915963/kidney-transplant-recipients-requiring-critical-care-admission-within-one-year-of-transplant
#10
Okechukwu O Okidi, David Van Dellen, Cassandra Sobajo, Angela Summers, John R Greer, Titus Augustine
OBJECTIVES: Kidney transplant is the gold standard for treatment of renal failure. With the increasing age of the recipient population, which carries significant comorbidities, and the use of more marginal organs, there is potential for increased critical care admissions. In this study, we investigated the incidence, indications, and outcomes of patients admitted to critical care within 1 year of transplant. We also aimed to identify any precipitating factors or events that may trigger these admissions, as well as establish variables that could affect mortality...
December 2, 2016: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/27915164/can-the-cerebral-regional-oxygen-saturation-be-a-perfusion-parameter-in-shock
#11
Ashraf Al Tayar, Amr Abouelela, Khaja Mohiuddeen
INTRODUCTION: Shock, defined as a state of tissue hypoperfusion and the tissues reperfusion, is the main goal of management of shock. Increase in central venous saturation (CvSo2) and decrease in blood lactate level are useful in assessment of adequacy of tissue perfusion. Near-infrared spectroscopy is a noninvasive way to observe real-time changes in regional cerebral saturation and has been used in patients with different brain diseases. There is a small body of literature suggesting that cerebral regional oxygen saturation (CrSo2) monitoring added a value in assessment and management of intensive care unit (ICU) patients...
November 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27914358/defining-the-role-of-perioperative-statin-treatment-in-patients-after-cardiac-surgery-a-meta-analysis-and-systematic-review-of-20-randomized-controlled-trials
#12
Xin Yuan, Jianlin Du, Qi Liu, Ling Zhang
BACKGROUND: Although statin use has been indicated to prevent atrial fibrillation in previous observational and experimental trials, the issue remains inadequately and insufficiently explored. We therefore performed this meta-analysis to evaluate the effects of perioperative statin therapy on complications and short-term prognosis following cardiac surgery. METHODS: A search of the PubMed, EMBASE and the Cochrane database of controlled trials was performed from inception to June 2016 to identify relevant randomized controlled trials (RCTs)...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27914275/inter-observer-agreement-of-the-general-movements-assessment-with-infants-following-surgery
#13
Cathryn Crowle, Claire Galea, Catherine Morgan, Iona Novak, Karen Walker, Nadia Badawi
BACKGROUND: The General Movements Assessment (GMA) is a validated and reliable method of identifying infants at risk of adverse neurodevelopmental outcomes, however there is minimal data available on the use of the GMA with infants following surgery. AIMS: The aim of this study was to investigate the inter-observer agreement for the GMA with this infant population. STUDY DESIGN: Reliability and agreement study. SUBJECTS: This was a prospective cohort study of 190 infants (male n=112) born at term (mean 38weeks, SD 2weeks)...
November 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/27912981/examining-the-association-between-surface-bioburden-and-frequently-touched-sites-in-intensive-care
#14
C E Adams, J Smith, V Watson, C Robertson, S J Dancer
BACKGROUND: Critical care patients are at increased risk of infection. Near-patient surfaces act as reservoirs of microbial soil, which may contain pathogens. AIM: To correlate soil levels with hand-touch frequency of near-patient sites in an intensive care unit (ICU). METHODS: Five sites around each bed in a 10-bed ICU were screened for total microbial soil (cfu/cm(2)) and Staphylococcus aureus every month for 10 months. Selected sites were infusion pump and cardiac monitor, left and right bedrails, and bed table...
November 13, 2016: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27912070/cardiac-complications-associated-with-the-influenza-viruses-a-subtype-h7n9-or-pandemic-h1n1-in-critically-ill-patients-under-intensive-care
#15
Jiajia Wang, Hua Xu, Xinjing Yang, Daguo Zhao, Shenlang Liu, Xue Sun, Jian-An Huang, Qiang Guo
BACKGROUND AND OBJECTIVE: The clinical presentations and disease courses of patients hospitalized with either influenza A virus subtype H7N9 (H7N9) or 2009 pandemic H1N1 influenza virus (pH1N1) were compared in a recent report, but associated cardiac complications remain unclear. The present retrospective study investigated whether cardiac complications in critically ill patients with H7N9 infections differed from those infected with the pH1N1 strain. METHODS: Suspect cases were confirmed by reverse transcription polymerase chain reaction assays with specific confirmation of the pandemic H1N1 strain at the Centers for Disease Control and Prevention...
November 29, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27909593/our-anaesthetic-experiences-in-patients-undergoing-percutaneous-mitraclip-implantation
#16
Ezgi Erkılıç, Elvin Kesimci, Cihan Döğer, Tülin Gümüş, Süleyman Ellik, Orhan Kanbak
OBJECTIVE: Percutaneous mitraclip implantation system, is a new technique developed for patients with high surgical risks. It is generally performed in a catheterisation laboratory with the guidance of fluoroscopy and transesophageal echocardiography. In this study, we aimed to share our experiences on anaesthetic in patients undergoing mitraclip implantation under general anaesthesia. METHODS: Eighty four patients with severe, symptomatic mitral insufficiency, who had undergone MitraClip implantation under general anaesthesia between July 2012 and March 2015 (54 male, 30 female; mean age: 68...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27908944/use-of-neuromuscular-blockers-during-therapeutic-hypothermia-after-cardiac-arrest-a-nursing-protocol
#17
Coraline Boulila, Samia Ben Abdallah, Aude Marincamp, Vincent Coic, Romuald Lauverjat, Nicole Ericher, Wulfran Bougouin, Jean-Paul Mira, Alain Cariou, Guillaume Geri
BACKGROUND: Neuromuscular blockers used to prevent shivering during therapeutic hypothermia in comatose patients after out-of-hospital cardiac arrest are associated with adverse events. OBJECTIVE: To assess the influence of a nurse-implemented protocol on use of neuromuscular blockers in patients treated with 24-hour therapeutic hypothermia after out-of-hospital cardiac arrest. METHODS: A before and after study was done in a 24-bed cardiac arrest center...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#18
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907878/ultrasound-in-cardiac-trauma
#19
Theodosios Saranteas, Andreas F Mavrogenis, Christina Mandila, John Poularas, Fotios Panou
In the perioperative period, the emergency department or the intensive care unit accurate assessment of variable chest pain requires meticulous knowledge, diagnostic skills, and suitable usage of various diagnostic modalities. In addition, in polytrauma patients, cardiac injury including aortic dissection, pulmonary embolism, acute myocardial infarction, and pericardial effusion should be immediately revealed and treated. In these patients, arrhythmias, mainly tachycardia, cardiac murmurs, or hypotension must alert physicians to suspect cardiovascular trauma, which would potentially be life threatening...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27904574/comparison-of-early-period-results-of-blood-use-in-open-heart-surgery
#20
Serhat Huseyin, Volkan Yuksel, Orkut Guclu, Fatma Nesrin Turan, Suat Canbaz, Turan Ege, Hasan Sunar
BACKGROUND: Various adverse effects of homologous blood transfusion detected particularly in open heart surgery, in which it is frequently used, lead researchers to study on autologous blood use and to evaluate the patient's blood better. Due to the complications of homologous blood transfusion, development of techniques that utilize less transfusion has become inevitable. We aimed to evaluate the effects of acute normovolemic hemodilution (ANH) in patients undergoing open heart surgery...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
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