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Cardiac intensive care

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https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#1
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530779/predictive-factors-for-early-hospital-readmission-and-1-year-mortality-in-elder-patients-following-surgical-treatment-of-a-hip-fracture
#2
Hakan Sofu, Hanifi Üçpunar, Yalkın Çamurcu, Serda Duman, Mehmet Nuri Konya, Sarper Gürsu, Vedat Şahin
BACKGROUND: Early hospital readmission after surgically treated hip fracture is a common entity, often involving an adverse event and causing strains on an already overburdened healthcare system. The main purposes of the present study were to determine the 30-day readmission rate, analyze the predictive factors for early hospital readmissions, and assess 1-year mortality following surgical treatment of hip fracture in elderly patients. Retrospective case-control study. METHODS: In total, 517 patients with a mean age of 74 years were evaluated...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28530332/-treatment-of-mechanically-ventilated-patients-in-an-internal-medicine-department-overview-2013
#3
Jacov Kogan, Alex Rodnitsky, Ornit Cohen, Svetlana Turkot, Yevgenia Tziba, Boris Golzman
BACKGROUND: Over recent years the number of mechanically ventilated patients in internal medicine departments has grown. These patients are elderly, mostly disabled and suffer from many chronic illnesses. Most of them require prolonged mechanical ventilation. OBJECTIVES: The study aimed to evaluate the population of mechanically ventilated patients in an internal department, the treatment and outcomes, particularly the morbidity in hospitalization and to identify the prognostic causes of death...
August 2016: Harefuah
https://www.readbyqxmd.com/read/28528465/contrast-induced-nephropathy-cin-of-patients-with-renal-dysfunction-in-ct-examination
#4
Yasuhiro Fukushima, Hitomi Miyazawa, Junpei Nakamura, Ayako Taketomi-Takahashi, Takayuki Suto, Yoshito Tsushima
PURPOSE: To investigate the incidence and risk factors of contrast induced nephropathy (CIN) after contrast enhanced (CE) computed tomography (CT) in patients with renal dysfunction. MATERIALS AND METHODS: Two hundred sixteen inpatients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m(2) underwent CE CT using iodine doses of 420 or 480 mg I/kg. Data of all enrolled patients was collected for baseline serum creatinine level (SCr), post-CE CT SCr within 3 days after CE CT, and conditions considered risk factors for CIN [renal dysfunction, contrast media dose, advanced age, diabetes mellitus, no intravenous hydration, cardiac dysfunction (left ventricular ejection fraction <60%) and intensive-care unit (ICU) admission]...
May 20, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#5
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28520538/treatment-strategies-for-paradoxical-hypertension-following-surgical-correction-of-coarctation-of-the-aorta-in-children
#6
Peter P Roeleveld, Eline G Zwijsen
BACKGROUND: Paradoxical hypertension after repair of coarctation of the aorta is a well-known phenomenon. The pathogenesis involves the activation of the sympathetic nervous system (first phase) and renin-angiotensin system (second phase). Only a limited number of different treatment strategies have been published in the literature, without any comparative studies. METHODS: Our aim was to describe the current international practice variation surrounding pharmacological treatment currently being employed to treat paradoxical hypertension following the repair of coarctation of the aorta in children...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28515741/respiratory-functional-status-after-conventional-and-minimally-invasive-aortic-valve-replacement-surgery-a-propensity-score-analysis
#7
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Kamil Fijorek, Michał Mędrzycki, Janusz Andres, Bogusław Kapelak
INTRODUCTION: Reports describing respiratory function of patients after conventional or minimally invasive cardiac surgery are infrequent. AIM: To compare pulmonary functional status after conventional (AVR) and after minimally invasive, through right anterior minithoracotomy, aortic valve replacement (RT-AVR). MATERIAL AND METHODS: This was an observational analysis of 212 patients scheduled for RT-AVR and 212 for AVR between January 2011 and December 2014 selected using propensity score matching...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28511986/epileptiform-discharge-detection-with-the-4-channel-frontal-electroencephalography-during-post-resuscitation-care
#8
Kyoung Min You, Gil Joon Suh, Woon Yong Kwon, Kyung Su Kim, Sang-Bae Ko, Min Ji Park, Taegyun Kim, Jung-In Ko
INTRODUCTION: We performed this study to investigate whether the SEDline system, a 4-channel-processed electroencephalography (EEG) monitoring device in the frontal area, can detect epileptiform discharges accurately during post-resuscitation care in comatose cardiac arrest survivors. METHODS: Adult comatose cardiac arrest survivors, who were admitted to the intensive care unit (ICU) for post-resuscitation care including TTM, were enrolled. Within 72h post-return of spontaneous circulation (ROSC), conventional EEG was conducted for 30minutes...
May 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28511984/comparison-of-three-cognitive-exams-in-cardiac-arrest-survivors
#9
Allison C Koller, Jon C Rittenberger, Melissa J Repine, Patrick W Morgan, Jeffrey Kristan, Clifton W Callaway
BACKGROUND: Cognitive deficits may detract from quality of life after cardiac arrest. Their pattern and prevalence are not well documented. We used the Computer Assessment of Mild Cognitive Impairment (CAMCI), the Montreal Cognitive Assessment (MOCA) and the 41 Cent Test (41CT) to assess cognitive impairment in cardiac arrest survivors and examine the exams' diagnostic accuracy. We hypothesized that the scores of these exams would indicate the presence of cognitive impairment in arrest survivors, that the overall scores on the three study assessments would correlate with one another, and that the 41CT, MOCA, and executive function element of the CAMCI would vary independently from other non-executive CAMCI components, reflecting executive function impairment after cardiac arrest...
May 13, 2017: Resuscitation
https://www.readbyqxmd.com/read/28511403/a-prospective-analysis-of-drug-interactions-in-patients-of-intensive-cardiac-care-unit
#10
Shipra Jain, Pushpawati Jain, Kopal Sharma, Pushpendra Saraswat
INTRODUCTION: Drug-Drug Interaction (DDI) is a serious concern in cardiac patients due to polypharmacy. AIM: The present study was aimed to identify the potential DDI among hospitalized cardiac patients and evaluate the mechanism and severity of such interactions. MATERIALS AND METHODS: A prospective observational study was conducted in intensive cardiac care unit of a tertiary care hospital for six months. Patients aged 18 years and above and taking two or more drugs were included in the study...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509706/length-of-stay-mortality-cost-and-perceptions-of-care-associated-with-transition-from-an-open-to-closed-staffing-model-in-the-cardiac-intensive-care-unit
#11
Jason N Katz, Anton Lishmanov, Sean van Diepen, Dongqing Yu, Haipeng Shen, Eric Pauley, Jatin Bhatia, Adam Buntaine, Arun Das, Cristie Dangerfield, Brooke McLaughlin, George A Stouffer, Prashant Kaul
BACKGROUND: Organizational models in the intensive care unit (ICU) have classically been described as either closed or open, depending on the presence or absence of a dedicated ICU team. Although a closed model has been shown to improve patient outcomes in medical and surgical ICUs, the merits of various care models have not been previously explored in the cardiac ICU (CICU) setting. METHODS: From November 2012 to March 2014, data were prospectively collected on all admissions before and after transition from an open to closed CICU at our institution...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28506913/predicting-determinants-of-atrial-fibrillation-or-flutter-for-therapy-elucidation-in-patients-at-risk-for-thromboembolic-events-predate-af-study
#12
Javed M Nasir, William Pomeroy, Adam Marler, Matthew Hann, Tina Baykaner, Ronald Jones, Richard Stoll, Katherine Hursey, Angela Meadows, Jennifer Walker, Steve Kindsvater
BACKGROUND: Atrial fibrillation (AF) is the most common clinically significant cardiac rhythm disorder. There is considerable interest in screening for AF, as it is a leading cause of stroke, and oral anticoagulants (OACs) have been shown to significantly reduce the risk of stroke in patients with AF. Improved screening for AF with subsequent treatment may help improve long-term outcomes, but the optimal patient population and screening intensity are unknown. OBJECTIVES: In this study, we prospectively evaluated the use of the CHA2DS2-VASc score for the prediction of new-onset AF using insertable cardiac monitors (ICMs) and examined whether this screening led to the initiation of OAC therapy...
May 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28506648/antegrade-versus-continuous-retrograde-del-nido-cardioplegia-in-the-david-i-operation
#13
Xuan Jiang, Tianxiang Gu, Enyi Shi, Chun Wang, Zongyi Xiu, Guangwei Zhang
BACKGROUND: The efficacy of continuous retrograde del Nido cardioplegia for myocardial protection is still controversial. We hypothesised that antegrade and retrograde cardioplegia offer equivalent safety for myocardial protection in the David I procedure. METHODS: We retrospectively reviewed 33 patients undergoing the David I operation with antegrade or retrograde del Nido solution from June 2014 to January 2016. The outcomes were compared. The follow-up was 1 month to 15 months...
April 26, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28506458/impact-of-postoperative-hypothermia-on-outcomes-in-coronary-artery-bypass-surgery-patients
#14
Pey-Jen Yu, Hugh A Cassiere, Nina Kohn, Allan Mattia, Alan R Hartman
OBJECTIVES: To determine the impact of postoperative hypothermia on outcomes in coronary artery bypass graft surgery (CABG) patients. DESIGN: A retrospective study was performed on patients who underwent isolated CABG between 2011 and 2014. SETTING: Single-center study at a university hospital. PARTICIPANTS: All patients who underwent isolated CABG with cardiopulmonary bypass between 2011 and 2014. INTERVENTIONS: Patients underwent isolated CABG on cardiopulmonary bypass...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28506244/early-eeg-for-outcome-prediction-of-postanoxic-coma-prospective-cohort-study-with-cost-minimization-analysis
#15
Lotte Sondag, Barry J Ruijter, Marleen C Tjepkema-Cloostermans, Albertus Beishuizen, Frank H Bosch, Janine A van Til, Michel J A M van Putten, Jeannette Hofmeijer
BACKGROUND: We recently showed that electroencephalography (EEG) patterns within the first 24 hours robustly contribute to multimodal prediction of poor or good neurological outcome of comatose patients after cardiac arrest. Here, we confirm these results and present a cost-minimization analysis. Early prognosis contributes to communication between doctors and family, and may prevent inappropriate treatment. METHODS: A prospective cohort study including 430 subsequent comatose patients after cardiac arrest was conducted at intensive care units of two teaching hospitals...
May 15, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28505685/-weaning-unit-of-the-university-medicine-greifswald-institutional-structure-and-weaning-results-from-prolonged-ventilation-over-10-years
#16
A Müller-Heinrich, C Warnke, A Heine, T Bollmann, M Boesche, C Schäper, B Stubbe, S Friesecke, S B Felix, S Gläser, A Obst, R Ewert
The increasing importance of intensive care medicine including mechanical ventilation has been accompanied by the demand of weaning opportunities for patients undergoing prolonged mechanical ventilation. Consequently, specialised clinical institutions, focusing on the weaning from mechanical ventilation, have been established since the 1980 s.The present article illustrates the structural development and results of such a specialised institution at the University Medicine Greifswald, using data of 616 patients collected within the past ten years (2006 - 2015)...
May 15, 2017: Pneumologie
https://www.readbyqxmd.com/read/28504990/a-structured-transfer-of-care-process-reduces-perioperative-complications-in-cardiac-surgery-patients
#17
Michael Hall, Jamie Robertson, Matthias Merkel, Michael Aziz, Michael Hutchens
INTRODUCTION: Serious complications are common during the intensive care of postoperative cardiac surgery patients. Some of these complications may be influenced by communication during the process of handover of care from the operating room to the intensive care unit (ICU) team. A structured transfer of care process may reduce the rate of communication errors and perioperative complications. METHODS: We hypothesized that a collaborative, comprehensive, structured handover of care from the intraoperative team to the ICU team would reduce a specific set of postoperative complications...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28504982/characteristics-in-hospital-management-and-outcome-of-late-acute-st-elevation-myocardial-infarction-presenters
#18
Enrico Cerrato, Davide Forno, Silvia Ferro, Alessandra Chinaglia
BACKGROUND: Patients with delayed presentation of acute myocardial infarction with ST-segment elevation (STEMI) frequently have a poor prognosis but literature about acute complications in intensive cardiac care unit (ICCU) and in-hospital outcome are still limited. METHODS: All STEMI patients admitted to our institution between June 2007 and December 2013 were divided into patients presenting more than 12 h after symptom onset (lateSTEMI) and within 12 h (STEMI)...
May 12, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28504565/early-intensive-statin-treatment-reduces-hard-cardiovascular-outcomes-after-acute-coronary-syndrome
#19
Gregory G Schwartz, Rana Fayyad, Michael Szarek, David DeMicco, Anders G Olsson
Background Early, intensive statin treatment is the standard of care after acute coronary syndrome (ACS). However, the benefit of this approach to prevent major adverse cardiovascular events has been demonstrated in only one randomised, placebo controlled trial. The Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial demonstrated that atorvastatin 80 mg daily, compared with placebo, reduced time to first occurrence of death, non-fatal myocardial infarction, resuscitated cardiac arrest, or hospitalisation for unstable angina (stroke not included) during the 16 week period following ACS...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28503704/use-of-eeg-in-critically-ill-children-and-neonates-in-the-united-states-of-america
#20
Marina Gaínza-Lein, Iván Sánchez Fernández, Tobias Loddenkemper
The objective of the study was to estimate the proportion of patients who receive an electroencephalogram (EEG) among five common indications for EEG monitoring in the intensive care unit: traumatic brain injury (TBI), extracorporeal membrane oxygenation (ECMO), cardiac arrest, cardiac surgery and hypoxic-ischemic encephalopathy (HIE). We performed a retrospective cross-sectional descriptive study utilizing the Kids' Inpatient Database (KID) for the years 2010-2012. The KID is the largest pediatric inpatient database in the USA and it is based on discharge reports created by hospitals for billing purposes...
May 13, 2017: Journal of Neurology
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