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https://www.readbyqxmd.com/read/29773957/perioperative-predictors-of-delirium-and-incidence-factors-in-adult-patients-post-cardiac-surgery
#1
Stavros Theologou, Konstantinos Giakoumidakis, Christos Charitos
Background: Delirium is a quite common complication in adult patients post-cardiac surgery. The purpose of our study was to identify perioperative characteristics and also focus on incidence factors that could predict delirium in the cardiac surgery intensive care unit (CICU) postoperatively. Methods: We conducted a prospective study of 179 consecutive patients, who underwent open-heart surgical operation and were admitted to the CICU of a general tertiary hospital in Athens, Greece...
2018: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29770293/current-monitoring-and-innovative-predictive-modeling-to-improve-care-in-the-pediatric-cardiac-intensive-care-unit
#2
REVIEW
Mary K Olive, Gabe E Owens
The objectives of this review are (I) to describe the challenges associated with monitoring patients in the pediatric cardiac intensive care unit (PCICU) and (II) to discuss the use of innovative statistical and artificial intelligence (AI) software programs to attempt to predict significant clinical events. Patients cared for in the PCICU are clinically fragile and at risk for fatal decompensation. Current monitoring modalities are often ineffective, sometimes inaccurate, and fail to detect a deteriorating clinical status in a timely manner...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29770244/predicting-length-of-stay-in-intensive-care-units-after-cardiac-surgery-comparison-of-artificial-neural-networks-and-adaptive-neuro-fuzzy-system
#3
Hamidreza Maharlou, Sharareh R Niakan Kalhori, Shahrbanoo Shahbazi, Ramin Ravangard
Objectives: Accurate prediction of patients' length of stay is highly important. This study compared the performance of artificial neural network and adaptive neuro-fuzzy system algorithms to predict patients' length of stay in intensive care units (ICU) after cardiac surgery. Methods: A cross-sectional, analytical, and applied study was conducted. The required data were collected from 311 cardiac patients admitted to intensive care units after surgery at three hospitals of Shiraz, Iran, through a non-random convenience sampling method during the second quarter of 2016...
April 2018: Healthcare Informatics Research
https://www.readbyqxmd.com/read/29770219/determinants-and-prognosis-of-high-sensitivity-cardiac-troponin-t-peak-plasma-concentration-in-patients-hospitalized-for-non-cardiogenic-shock
#4
Marie Caujolle, Jerome Allyn, Caroline Brulliard, Dorothée Valance, David Vandroux, Olivier Martinet, Nicolas Allou
Purpose: The aim of this study was to assess the determinants and prognostic value of high-sensitivity cardiac troponin T peak plasma concentration in intensive care unit patients with non-cardiogenic shock. Material and methods: A prospective observational cohort study was conducted in a single intensive care unit between November 2014 and December 2015. Results: During the study period, 206 patients were hospitalized in the intensive care unit for non-cardiogenic shock and the median peak high-sensitivity cardiac troponin T was 55...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29768359/case-report-of-gastric-distension-due-to-superior-mesenteric-artery-syndrome-mimicking-hollow-viscus-perforation-considerations-in-critical-care-ultrasound
#5
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764556/-extra-longtime-continuous-chest-compression-to-rescue-cardiopulmonary-arrest-a-case-report-and-the-literature-review
#6
Yan Zhang, Tianxue Yue, Kexin Sun, Jiang Wang, Ruiwu Zhu
The new cardiopulmonary resuscitation (CPR) guideline emphasize the importance of chest compression, which was considered as the first step to CPR. The duration for CPR is usually limited to 30 minutes. With the development of new technology and evidence-based medicine, the success of extra longtime CPR has become possible, which is of great significance to some patients with cardiac arrest (CA), but the time limit has not been determined. On February 23rd in 2016, a 76-year-old female patient with respiratory and cardiac arrest who was on the third day after transurethral resection of bladder tumor (TUR-BT) was admitted to the intensive care unit of the General Hospital of Fushun Mining Bureau...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29764550/-predictive-value-of-central-venous-to-arterial-carbon-dioxide-partial-pressure-difference-for-fluid-responsiveness-in-septic-shock-patients-a-prospective-clinical-study
#7
Guangyun Liu, Huibin Huang, Hanyu Qin, Bin Du
OBJECTIVE: To evaluate the accuracy of central venous-to-arterial carbon dioxide partial pressure difference (Pcv-aCO2 ) before and after rapid rehydration test (fluid challenge) in predicting the fluid responsiveness in patients with septic shock. METHODS: A prospective observation was conducted. Forty septic shock patients admitted to medical intensive care unit (ICU) of Peking Union Medical College Hospital from October 2015 to June 2017 were enrolled. All of the patients received fluid challenge in the presence of invasive hemodynamic monitoring...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#8
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29762304/effectiveness-and-harms-of-pharmacological-interventions-in-the-treatment-of-delirium-in-adults-in-intensive-care-units-post-cardiac-surgery-a-systematic-review-protocol
#9
Vivienne Leigh, Catalin Tufanaru, Rosalind Elliott
The review objective is to synthesize the best available evidence on the effectiveness and harms of pharmacological interventions in the treatment of delirium in adults in intensive care units (ICU) after cardiac surgery.The specific review question is: What is the effectiveness and what are the harms of pharmacological interventions in relation to the duration and severity of delirium episodes, length of stay in ICU, length of stay in hospital, functional capacity and quality of life and mortality for critically ill adult patients treated in intensive care after cardiac surgery?...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29761259/-sense-of-coherence-scale-according-to-antonovsky-as-a-possible-predictor-for-return-to-work-for-cardiac-surgery-intensive-care-patients
#10
C Benstoem, R Wübker, M Lüngen, T Breuer, G Marx, R Autschbach, A Goetzenich, H Schnoering
BACKGROUND: For cardiac surgery patients who were employed prior to surgery, the return to their professional life is of special importance. In addition to medical reasons, such as pre-existing conditions, the success of the operation or postoperative course and patient-intrinsic reasons, which can be assessed with the Sense of Coherence (SOC) scale by Antonovsky, may also play a role in the question of a possible return into working life. METHODS: In this study 278 patients (invasive coronary artery bypass graft surgery and/or surgery on heart valves, age < 60 years, employed) were questioned postoperatively via post with the SOC questionnaire...
May 14, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29759717/low-level-vagus-nerve-stimulation-suppresses-post-operative-atrial-fibrillation-and-inflammation-a-randomized-study
#11
Stavros Stavrakis, Mary Beth Humphrey, Benjamin Scherlag, Omer Iftikhar, Purvi Parwani, Mubasher Abbas, Adrian Filiberti, Christian Fleming, Yanqing Hu, Paul Garabelli, Arthur McUnu, Marvin Peyton, Sunny S Po
OBJECTIVES: This study sought to examine the efficacy of low-level vagus nerve stimulation (LLVNS) in suppressing post-operative atrial fibrillation (POAF) and inflammatory cytokines in patients undergoing cardiac surgery. BACKGROUND: POAF often complicates cardiac surgery. METHODS: Patients undergoing cardiac surgery were randomized to active or sham LLVNS. In all patients, a bipolar wire was sutured to the vagus nerve pre-ganglionic fibers alongside the lateral aspect of the superior vena cava...
September 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29754693/preoperative-6-minute-walk-distance-is-associated-with-postoperative-cognitive-dysfunction
#12
Kazuhiro Hayashi, Hideki Oshima, Miho Shimizu, Kiyonori Kobayashi, Shigeyuki Matsui, Yoshihiro Nishida, Akihiko Usui
BACKGROUND: Postoperative cognitive dysfunction (POCD) is a neurologic dysfunction that occurs after surgery. POCD persists for a long period, ranging from weeks to months, and affects a patient's quality of life. A 6-minute walk distance (6MWD) has been used to predict postoperative complications after several operations. The present study investigated whether there was an independent association of a low preoperative 6MWD with POCD in patients who underwent cardiac operations. METHODS: The study included 181 patients who underwent a cardiac operation...
April 25, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29754664/investigation-of-motivational-interviewing-and-prevention-consults-to-achieve-cardiovascular-targets-impact-trial
#13
Eugenia Gianos, Antoinette Schoenthaler, Yu Guo, Judy Zhong, Howard Weintraub, Arthur Schwartzbard, James Underberg, Michael Schloss, Jonathan D Newman, Sean Heffron, Edward A Fisher, Jeffrey S Berger
BACKGROUND: Patients undergoing cardiovascular (CV) procedures often have suboptimal CV risk factor control and may benefit from strategies targeting healthy lifestyle behaviors and education. Implementation of prevention strategies may be particularly effective at this point of heightened motivation. METHODS: A prospective, randomized, pilot study was conducted in 400 patients undergoing a nonurgent CV procedure (cardiac catheterization ± revascularization) to evaluate the impact of different prevention strategies...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29753821/thromboelastography-is-associated-with-surrogates-for-bleeding-after-pediatric-cardiac-surgery
#14
Sirisha Emani, Lynn A Sleeper, David Faraoni, Michelle Mulone, Fatoumata Diallo, James A DiNardo, Juan Ibla, Sitaram M Emani
BACKGROUND: Perioperative bleeding is a common complication in pediatric patients undergoing cardiac surgery. Although thromboelastography (TEG) has been utilized in patients undergoing adult cardiac surgery, limited data are available in pediatric patients. We hypothesize that TEG parameters may be associated with surrogate endpoints for postoperative bleeding in pediatric patients undergoing complex cardiac surgery. METHODS: In a retrospective study, TEG was obtained after protamine administration and upon intensive care unit (ICU) admission in pediatric patients (≤ 18yrs) undergoing cardiac surgery requiring cardiopulmonary bypass...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29753550/rescue-procedure-for-an-electrical-storm-using-robotic-non-invasive-cardiac-radio-ablation
#15
Raphaël Jumeau, Mahmut Ozsahin, Juerg Schwitter, Véronique Vallet, Frédéric Duclos, Michele Zeverino, Raphaël Moeckli, Etienne Pruvot, Jean Bourhis
Stereotactic body radiotherapy (SBRT) is an emerging non-invasive treatment in the management of ventricular tachycardia (VT). We report here an intensive care patient suffering from an electrical storm due to incessant VT, unresponsive to catheter ablation and anti-arrhythmic drugs, showing an immediate and durable response to electrophysiology-guided cardiac SBRT.
May 9, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29752218/elevated-international-normalized-ratio-is-not-associated-with-increased-perioperative-morbidity-in-podiatric-limb-salvage-surgery-a-retrospective-analysis
#16
Nalini Vadivelu, Alice M Kai, Feng Dai, Hosni Mikhael, Rima Aouad, Peter Blume
The risk of hemorrhage always exists in anticoagulated patients with an elevated international normalized ratio (INR), a risk that must be measured against the necessity for surgical procedures. The objective of the present retrospective medical record study was to assess the safety with which limb salvage procedures can be conducted in patients with an INR >1.4. The medical records of 231 patients who had undergone limb salvage procedures by 1 surgeon at the Yale New Haven Health System from November 2008 through July 2014 were reviewed...
May 8, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29752055/predicting-intensive-care-unit-length-of-stay-after-cardiac-surgery
#17
EDITORIAL
Edward Litton, Michael McCann, Frank van Haren
No abstract text is available yet for this article.
April 6, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29751986/delirium-after-cardiac-surgery-incidence-phenotypes-predisposing-and-precipitating-risk-factors-and-effects
#18
Gianfranco Sanson, Yuliya Khlopenyuk, Sara Milocco, Massimiliano Sartori, Lorella Dreas, Adam Fabiani
BACKGROUND: In cardiac surgical patients little is known about different phenotypes of delirium and how the symptoms fluctuate over time. OBJECTIVES: Evaluate risk factors, incidence, fluctuations, phenotypic characteristics and impact on patients' outcomes of delirium. METHODS: Prospective longitudinal study. In postoperative intensive care unit 199 patient were assessed three-times a day through an adapted versions of the Intensive Care Delirium Screening Checklist...
May 8, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29751629/current-evidence-about-nutrition-support-in-cardiac-surgery-patients-what-do-we-know
#19
REVIEW
Aileen Hill, Ekaterina Nesterova, Vladimir Lomivorotov, Sergey Efremov, Andreas Goetzenich, Carina Benstoem, Mikhail Zamyatin, Michael Chourdakis, Daren Heyland, Christian Stoppe
Nutrition support is increasingly recognized as a clinically relevant aspect of the intensive care treatment of cardiac surgery patients. However, evidence from adequate large-scale studies evaluating its clinical significance for patients&rsquo; mid- to long-term outcome remains sparse. Considering nutrition support as a key component in the perioperative treatment of these critically ill patients led us to review and discuss our understanding of the metabolic response to the inflammatory burst induced by cardiac surgery...
May 11, 2018: Nutrients
https://www.readbyqxmd.com/read/29750254/clinical-significance-of-atrial-kick
#20
Vinod Namana, Sushilkumar Satish Gupta, Nitin Sabharwal, Gerald Hollander
A 68-year-old man with a history of diabetes mellitus type II, hypertension and active smoking was transferred to our hospital from a nearby hospital for coronary artery bypass graft (CABG) surgery after suffering a complicated inferior wall myocardial infarction (IWMI). Post the initial angioplasty, the patient developed in-stent thrombosis and became hypotensive with a systolic blood pressure < 90 mmHg. After hemodynamic stability was achieved he was transferred to our hospital. During his stay, the cardiac monitor showed fluctuations in his blood pressure with a drop in systolic blood pressure by 10 to 15 mmHg and diastolic blood pressure by 10 mmHg when he developed atrioventricular (AV) dissociation during an idioventricular rhythm...
May 10, 2018: QJM: Monthly Journal of the Association of Physicians
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