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Mechanical ventilation myocardial infarction

Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
C Savelkoul, A F Klijnsma, E Balk, A Janse, D H T Tjan
Acute intensive care (IC) triage involves a challenging decision-making process. Physicians are required to make life or death decisions about an unfamiliar patient within a short time frame. An 84-year-old female was admitted to the stroke unit following an extensive cerebral infarction. The intensive care unit (ICU) physician was consulted because of a suspected severe abdominal sepsis even though ICU treatment had never previously been discussed. A 77-year-old female with a previous history of myocardial infarction and severe COPD developed acute respiratory failure on the ward, and was admitted to the ICU for support by a mechanical ventilator...
2016: Nederlands Tijdschrift Voor Geneeskunde
Mayuresh Chaudhari, Sonu Sharma, Rajesh Kumar Jha, Ramandeep Singh Ahuja, Sandeep Bansal
Primary varicella infection in an immunocompetent young adult is very rare, but it has a high mortality rate due to serious complications. We report a rare association of varicella pneumonia presenting in acute respiratory distress with mild chest pain, however with electrocardiographic and biochemical markers suggestive of acute ST elevation myocardial infarction. Coronary angiography was done to exclude infarction, serum antibody titers confirmed varicella, acyclovir was started, and ARDS was successfully treated with steroid pulse therapy and mechanical ventilator support...
September 2016: Indian Heart Journal
Jiri Parenica, Jiri Jarkovsky, Jan Malaska, Alexandre Mebazaa, Jana Gottwaldova, Katerina Helanova, Jiri Litzman, Milan Dastych, Josef Tomandl, Jindrich Spinar, Ludmila Dostalova, Petr Lokaj, Marie Tomandlova, Monika Goldergova Pavkova, Pavel Sevcik, Matthieu Legrand
INTRODUCTION: Cardiogenic shock (CS) patients are at a high risk of developing infectious complications; however, their early detection is difficult, mainly due to a frequently occurring non-infectious inflammatory response, which accompanies an extensive myocardial infarction or a post-cardiac arrest syndrome. The goal of our prospective study was to describe infectious complications in CS and the immune/inflammatory response based on a serial measurement of several blood-based inflammatory biomarkers...
September 29, 2016: Shock
Cory G Couch, Mariano E Menendez, C Lowry Barnes
BACKGROUND: Epilepsies is a spectrum of brain disorders ranging from severe, life threatening, and disabling to more benign, but little is known about its impact in the perioperative arthroplasty setting. We sought to determine whether epileptic patients undergoing elective total joint arthroplasty (TJA) would be at increased risk for in-hospital complications and death, prolonged stay, and nonroutine discharge. METHODS: Using discharge records from the Nationwide Inpatient Sample (2002-2001), we identified 6,054,344 patients undergoing elective primary TJA, of whom 31,865 (0...
August 20, 2016: Journal of Arthroplasty
Jorrit S Lemkes, Gladys N Janssens, Heleen M Oudemans-van Straaten, Paul W Elbers, Nina W van der Hoeven, Jan G P Tijssen, Luuk C Otterspoor, Michiel Voskuil, Joris J van der Heijden, Martijn Meuwissen, Tom A Rijpstra, Georgios J Vlachojannis, Raoul M van der Vleugel, Koen Nieman, Lucia S D Jewbali, Gabe B Bleeker, Rémon Baak, Bert Beishuizen, Martin G Stoel, Pim van der Harst, Cyril Camaro, José P S Henriques, Maarten A Vink, Marcel T M Gosselink, Hans A Bosker, Harry J G M Crijns, Niels van Royen
BACKGROUND: Ischemic heart disease is a major cause of out-of-hospital cardiac arrest. The role of immediate coronary angiography (CAG) and percutaneous coronary intervention (PCI) after restoration of spontaneous circulation following cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) remains debated. HYPOTHESIS: We hypothesize that immediate CAG and PCI, if indicated, will improve 90-day survival in post-cardiac arrest patients without signs of STEMI...
October 2016: American Heart Journal
R de la Espriella-Juan, A Valls-Serral, B Trejo-Velasco, A Berenguer-Jofresa, Ó Fabregat-Andrés, D Perdomo-Londoño, C Albiach-Montañana, J V Vilar-Herrero, D Sanmiguel-Cervera, E Rumiz-Gonzalez, S Morell-Cabedo
OBJECTIVE: To analyze the use and impact of the intra-aortic balloon pump (IABP) upon the 30-day mortality rate and short-term clinical outcome of non-selected patients with ST-elevation acute myocardial infarction (acute STEMI) complicated by cardiogenic shock (CS). DESIGN: A single-center retrospective case-control study was carried out. SETTING: Coronary Care Unit. PATIENTS: Data were collected from 825 consecutive patients with acute STEMI admitted to a Coronary Care Unit from January 2009 to August 2015...
September 17, 2016: Medicina Intensiva
Ghulam Hussain, Hammad Azam, Mirza Ahmad Raza Baig, Naseem Ahmad
OBJECTIVES: To see the early post-operative outcomes of off-pump versus on-pump coronary artery bypass graft surgery. METHODS: This retrospective analytical study was conducted at Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Our Primary outcome variables were; necessity of inotropic support, nonfatal myocardial infarction, ICU stay, nonfatal stroke, new renal failure requiring dialysis and death within 30 days after operation. There were two groups of patients; Group-I (On-pump group) and Group-II (Off-pump Group)...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Samih Z Thalji, Anai N Kothari, Paul C Kuo, Michael J Mosier
OBJECTIVE: To examine the development of acute kidney injury (AKI) after burn injury as an independent risk factor for increased morbidity and mortality over initial hospitalization and 1-year follow-up. BACKGROUND: Variability in fluid resuscitation and difficulty recognizing early sepsis are major barriers to preventing AKI after burn injury. Expanding our understanding of the burden AKI has on the clinical course of burn patients would highlight the need for standardized protocols...
September 8, 2016: Annals of Surgery
Jacek Piątek, Anna Kędziora, Janusz Konstanty-Kalandyk, Grzegorz Kiełbasa, Marta Olszewska, Karol Wierzbicki, Irena Milaniak, Bryan HyoChan Song, Bogusław Kapelak, Tomasz Darocha
BACKGROUND: Coronary artery disease (CAD) is a major cause of death and disability in developed countries. Despite the fact that prevalence accrues with age, an increasing number of young patients suffering from CAD is being observed worldwide. The aim of this study is to describe the population of young adults suffering from CAD and requiring coronary artery bypass grafting (CABG), and to assess early outcomes after the procedure. METHODS: A retrospective cohort study analyzed 190 consecutive patients aged ≤50 years old that underwent CABG between 2010 and 2014...
2016: Heart Surgery Forum
Zuzana Motovska, Ota Hlinomaz, Roman Miklik, Milan Hromadka, Ivo Varvarovsky, Jaroslav Dusek, Jiri Knot, Jiri Jarkovsky, Petr Kala, Richard Rokyta, Frantisek Tousek, Petra Kramarikova, Bohumil Majtan, Stanislav Simek, Marian Branny, Jan Mrozek, Pavel Cervinka, Jiri Ostransky, Petr Widimsky
BACKGROUND: No randomized "head-to-head" comparison of the efficacy and safety of ticagrelor vs. prasugrel has been published in the seven years since the higher efficacy of these newer P2Y12 inhibitors were first demonstrated relative to clopidogrel. METHODS: This academic study was designed to compare the efficacy and safety of prasugrel and ticagrelor in acute myocardial infarction (AMI) treated with primary or immediate percutaneous coronary intervention (PCI)...
August 30, 2016: Circulation
José Carlos Llamas Reyes, Joaquín Valle Alonso, Javier Fonseca, Margarita Luque Santos, María de Los Ángeles Ruiz-Cabello Jiménez, Jay Braniff
AIM: To study all the elderly patients (≥75 years) who were admitted in an Intensive Care Unit (ICU) of a Spanish hospital and identify factors associated with mortality. PATIENTS AND METHODS: A retrospective, observational data collected prospectively in patients ≥75 years recruited from the ICU in the period of January 2004 to December 2010. RESULTS: During the study period, 1661 patients were admitted to our unit, of whom 553 (33.3%) were older than 75 years...
July 2016: Indian Journal of Critical Care Medicine
W Krahwinkel, E Schuler, M Liebetrau, A Meier-Hellmann, J Zacher, R Kuhlen
OBJECTIVE: Lowering of mortality rates in hospitals with mortality rates higher than accepted reference values for acute myocardial infarction (AMI), congestive heart failure (CHF), pneumonia, stroke, mechanical ventilation (MV) and colorectal surgery by using an external peer review process that identifies areas requiring rectification and implements protocols directed at improving these areas. DESIGN: Retrospective, observational, quality management study using administrative data to compare in-hospital mortality rates (pre and post an external peer review process that included adoption of improvement protocols) with reference values...
July 15, 2016: International Journal for Quality in Health Care
Russell D MacDonald, Felipe Allendes
OBJECTIVE: Transport of intra-aortic balloon pump (IABP)-dependent patients between hospitals is increasingly common. The transports are typically time-sensitive and require personnel familiar with IABP operation and management of a potentially unstable patient. This study examined transports performed by specially trained critical care paramedics in a large air medical and land critical care transport service. METHODS: This retrospective, descriptive review prospectively collected data for IABP-dependent patient transports in Ontario, Canada in a 10-year interval beginning September 2003...
July 2016: Air Medical Journal
Fábio Bucaretchi, Eduardo M De Capitani, Carla B Fernandes, Thiago M Santos, Igor A G Zamilute, Stephen Hyslop
CONTEXT: Stroke following scorpion stings is rare. We report a fatal envenomation involving multiple, extensive brain infarcts in a patient with a previous diagnosis of essential thrombocythemia (ET) who was stung by Tityus serrulatus (T. serrulatus). CASE DETAILS: A 44-year-old woman with a diagnosis of low-risk ET (platelets <1,000,000/mm(3), age <60 years and no history of thrombosis; positive JAK2V617F mutation) was admitted to a local ED 1 h after being stung by T...
July 8, 2016: Clinical Toxicology
Roop Kaw, Adrian V Hernandez, Vinay Pasupuleti, Abhishek Deshpande, Vijaiganesh Nagarajan, Hector Bueno, Craig I Coleman, John P A Ioannidis, Deepak L Bhatt, Eugene H Blackstone
OBJECTIVE: The objective of this study was to investigate the effect of preoperative diastolic dysfunction on postoperative mortality and morbidity after cardiovascular surgery. METHODS: We systematically searched for articles that assessed the prognostic role of diastolic dysfunction on cardiovascular surgery in PubMed, Cochrane Library, Web of Science, Embase, and Scopus until February 2016. Twelve studies (n = 8224) met our inclusion criteria. Because of the scarcity of outcome events, fixed-effects meta-analysis was performed via the Mantel-Haenszel method...
October 2016: Journal of Thoracic and Cardiovascular Surgery
Rudee Ting, Ambika Tejpal, Laura Finken, Mark Fisher, Charles Lefkowitz, Harikrishnan Parthasarathy, Brooks Fallis, Emil L Fosbol, Mohammad Al-Shehri, Michael Kutryk, Christopher E Buller, Neil Fam, John J Graham, Asim N Cheema, Akshay Bagai
BACKGROUND: In regional systems of ST-segment elevation myocardial infarction (STEMI) care, patients presenting to hospitals without percutaneous coronary intervention (PCI) are transferred to PCI-capable hospitals for primary PCI. Repatriation, a practice whereby such patients are transferred back to non-PCI referral hospitals after reperfusion is prevalent in many jurisdictions, yet little is known of this practice and its safety. METHODS: We studied 979 consecutive STEMI patients transported from the emergency department and catchment area of two non-PCI hospitals in Ontario, Canada to a regional PCI-hospital for primary PCI between January 2008 and June 2014...
July 2016: American Heart Journal
Bahar Aydınlı, Aslı Demir, Çiğdem Yıldırım Güçlü, Demet Bölükbaşı, E Utku Ünal, Rabia Koçulu, Gökçe Selçuk
PURPOSE: The present study was to investigate if five values that are part of the hemogram analysis routinely checked before heart surgeries can be used as a high-quality, quick, low-cost, and easy-to-use outcome predictor. METHODS: This investigation was a retrospective, observational, cross-sectional study. Univariate and multivariate logistic regression was used to identify independent predictors for combined adverse events. We enrolled 1500 consecutive patients who underwent elective, on-pump, open-heart surgery from 2011 to 2014...
October 2016: Journal of Anesthesia
Yaron Arbel, Ronen Mass, Tomer Ziv-Baran, Shafik Khoury, Gilad Margolis, Ben Sadeh, Nir Flint, Jeremy Ben-Shoshan, Talya Finn, Gad Keren, Yacov Shacham
BACKGROUND: Positive fluid balance has been associated with adverse outcomes in patients admitted to general intensive care units. We analysed the relationship between a positive fluid balance and its persistence over time in terms of in-hospital outcomes among ST elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock. METHODS: We retrospectively studied fluid intake and output for 96 hours following hospital admission in 48 consecutive adult patients with STEMI complicated by cardiogenic shock, all undergoing primary angioplasty...
June 8, 2016: European Heart Journal. Acute Cardiovascular Care
Akimasa Morisaki, Mitsuharu Hosono, Takashi Murakami, Masanori Sakaguchi, Yasuo Suehiro, Shinsuke Nishimura, Yoshito Sakon, Daisuke Yasumizu, Takumi Kawase, Toshihiko Shibata
OBJECTIVES: Deep sternal wound infection (DSWI) after cardiovascular surgery via median sternotomy remains a severe complication associated with a drastic decrease in the quality of life. We assessed the risk factors for in-hospital death caused by DSWI and the available treatments for DSWI. METHODS: Between January 1991 and August 2015, we retrospectively reviewed 73 patients (51 males and 22 females, mean age 67.5 ± 10.3 years) who developed DSWI after cardiovascular surgery via median sternotomy...
September 2016: Interactive Cardiovascular and Thoracic Surgery
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