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https://www.readbyqxmd.com/read/28327076/myocardial-protection-during-minimally-invasive-cardiac-surgery-through-right-mini-thoracotomy
#1
Micaela De Palo, Pietro Guida, Florinda Mastro, Daniela Nanna, Teresa A P Quagliara, Ruggiero Rociola, Giosuè Lionetti, Domenico Paparella
BACKGROUND: Myocardial damage is an independent predictor of adverse outcome following cardiac surgery and myocardial protection is one of the key factors to achieve successful outcomes. Cardioplegia with Custodiol is currently the most used cardioplegia during minimally invasive cardiac surgery (MICS). Different randomized controlled trials compared blood and Custodiol cardioplegia in the context of traditional cardiac surgery. No data are available for MICS. AIM: The aim of this study was to compare the efficacy of cold blood versus Custodiol cardioplegia during MICS...
April 2017: Perfusion
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#2
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28275227/halogenated-volatile-anesthetics-in-the-intensive-care-unit-current-knowledge-on-an-upcoming-practice
#3
Pascal L Langlois, Frederick D'Aragon, William Manzanares
The aim of this narrative review was to highlight key points of volatile anesthetics administration in the intensive care unit (ICU), including AnaConDa® and Mirus® devices characteristics and the reported findings on clinical outcomes in critically ill patients. Intravenous sedation in the ICU is associated with issues, such as over- and under-sedation. Halogenated compounds, which can be safely administered by inserting a device in any ICU ventilation circuit, have interesting pharmacodynamic and pharmacokinetic profiles for patients with multi-organ failure...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28260935/post-influenza-aspergillosis-do-not-underestimate-influenza-b
#4
REVIEW
Eric Fl Nulens, Marc Jc Bourgeois, Marijke Bml Reynders
Our objective is to highlight and focus on post-influenza aspergillosis, triggered by influenza B virus. This relatively new clinical entity is often associated with a fulminant course of respiratory decline and high mortality. A 51-year immunocompetent woman, without any medical history or risk factors for developing a complicated influenza infection, was admitted to the intensive care unit. During admission, she presented with an afebrile flu-like syndrome, myocarditis, rhabdomyolysis, multiple organ failure, and evolved to severe respiratory distress...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#5
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28215126/new-sepsis-definition-changes-incidence-of-sepsis-in-the-intensive-care-unit
#6
James N Fullerton, Kelly Thompson, Amith Shetty, Jonathan R Iredell, Harvey Lander, John A Myburgh, Simon Finfer
OBJECTIVE: To estimate the impact of adopting the proposed new diagnostic criteria for sepsis, based on Sequential Organ Failure Assessment (SOFA) criteria, on the diagnosis and apparent mortality of sepsis in Australian and New Zealand intensive care units. DESIGN, SETTING AND PARTICIPANTS: A two-stage, post hoc analysis of prospectively collected ICU research data from 3780 adult patients in 77 Australian and New Zealand ICUs on 7 study days, between 2009 and 2014...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28191382/inadvertent-skipping-of-steroids-in-septic-shock-leads-to-a-diagnosis-of-adult-onset-still-s-disease
#7
Vinoth K Sethuraman, Kavitha Balasubramanian, Stalin Viswanathan, Rajeswari Aghoram
Adult onset Still's disease is uncommon in middle-aged and elderly individuals and can rarely present with shock; shock is usually associated with disseminated intravascular coagulation, multiorgan dysfunction syndrome or acute respiratory distress syndrome. We report a post-menopausal woman with arthritis, fever, pneumonitis and hypotension which was managed as septic shock. Steroids were inadvertently missed during the second day of hospitalization in the intensive care unit. Persistence of hypotension on inotropes, with normal renal, hepatic and neurological function and recurrence of fever when steroids were skipped, led to suspicion of an inflammatory disorder...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28188064/the-impact-of-the-patient-post-intensive-care-syndrome-components-upon-caregiver-burden
#8
J Torres, D Carvalho, E Molinos, C Vales, A Ferreira, C C Dias, R Araújo, E Gomes
OBJECTIVE: To evaluate patient post-intensive care syndrome (PICS-P) and caregiver burden 3 months after discharge from the Intensive Care Unit (ICU) and determine the impact of different components of PICS-P upon caregiver burden. DESIGN: A prospective observational study was conducted over 26 months (January 2013-February 2015). SETTING: Medical-surgical ICU and follow-up consultation in Portugal. PATIENTS OR PARTICIPANTS: Patients discharged after a minimum of 2 days in the ICU...
February 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28182668/cross-sectional-study-of-mode-of-delivery-and-maternal-and-perinatal-outcomes-in-mainland-china
#9
Lei Hou, Susan Hellerstein, Allison Vitonis, Liying Zou, Yan Ruan, Xin Wang, Weiyuan Zhang
BACKGROUND: Cesarean delivery (CD) rates have risen globally with nearly 50% of the non-indicated CDs worldwide in China and Brazil. In China's One Child Policy era (1979-2015) most deliveries were women having their only child. Family size is a major determinant of the safety of medically non-indicated CD or CD on maternal request. The goal of this study is to document CD rates, indications, and analyze the relative safety of non-indicated CD compared to SVD and intrapartum CD. METHODS: Univariate and multivariate logistic regression analyses of the association between mode of delivery and short-term maternal and perinatal outcomes were performed on a cross-section of all deliveries at 39 hospitals in 14 provinces of China in 2011, presented as adjusted odds ratio (aOR), 99% confidence intervals (CI)...
2017: PloS One
https://www.readbyqxmd.com/read/28176472/suspected-atypical-haemolytic-uraemic-syndrome-in-two-post-partum-patients-with-foetal-death-in-utero-responding-to-eculizumab
#10
REVIEW
Justin Chua, Kathy Paizis, Simon Z He, Peter Mount
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) is a rare condition with the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Other conditions that present in a similar manner peri-partum include thrombotic thrombocytopaenic purpura, and pregnancy associated conditions including HELLP syndrome (haemolysis, elevated liver enzymes and low platelets), severe pre-eclampsia and less commonly acute fatty liver of pregnancy. CASE REPORTS: We describe two cases of suspected aHUS, who presented post-partum with foetal death-in-utero at 33 and 37 weeks respectively...
February 2017: Nephrology
https://www.readbyqxmd.com/read/28151493/surfactant-reduced-the-mortality-of-neonates-with-birth-weight-%C3%A2-1500%C3%A2-g-and-hypoxemic-respiratory-failure-a-survey-from-an-emerging-nicu-network
#11
H Wang, X Gao, C Liu, C Yan, X Lin, Y Dong, B Sun
OBJECTIVE: We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) ⩾1500 g and hypoxemic respiratory failure (HRF). STUDY DESIGN: We retrospectively analyzed 5650 patients with BW ⩾1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure ⩾24 h. The patients were allocated into groups of moderate preterm (1735, 30...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28146331/plasma-exchange-in-the-intensive-care-unit-technical-aspects-and-complications
#12
Aurélie Lemaire, Nathalie Parquet, Lionel Galicier, David Boutboul, Rémi Bertinchamp, Marion Malphettes, Guillaume Dumas, Eric Mariotte, Marie-Noëlle Peraldi, Virginie Souppart, Benoit Schlemmer, Elie Azoulay, Emmanuel Canet
BACKGROUND: Data on plasma exchange therapy in the intensive care unit (ICU) setting are scarce. We aimed to describe the technical aspects and the adverse events associated with the procedure in critically ill patients. METHODS: All adult patients treated by plasma exchange in the medical ICU of the Saint-Louis university hospital between January 1, 2013 and March 31, 2015 were prospectively included. RESULTS: We report on 260 plasma exchange procedures performed in 50 patients...
February 1, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28137395/cardiac-biomarkers-of-low-cardiac-output-syndrome-in-the-postoperative-period-after-congenital-heart-disease-surgery-in-children
#13
Juan L Pérez-Navero, María José de la Torre-Aguilar, Ignacio Ibarra de la Rosa, Mercedes Gil-Campos, Elena Gómez-Guzmán, Carlos Merino-Cejas, María C Muñoz-Villanueva, Francisco J Llorente-Cantarero
INTRODUCTION AND OBJECTIVES: To assess the predictive value of atrial natriuretic peptide, β-type natriuretic peptide, copeptin, mid-regional pro-adrenomedullin (MR-proADM) and cardiac troponin I (cTn-I) as indicators of low cardiac output syndrome in children with congenital heart disease undergoing cardiopulmonary bypass (CPB). METHODS: After corrective surgery for congenital heart disease under CPB, 117 children (aged 10 days to 180 months) were enrolled in a prospective observational pilot study during a 2-year period...
October 27, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28127828/psychiatric-symptomatology-after-delirium-a-systematic-review
#14
REVIEW
Clare Langan, Deep P Sarode, Tom C Russ, Susan D Shenkin, Alan Carson, Alasdair M J Maclullich
Delirium is an acute and usually transient severe neuropsychiatric syndrome associated with significant long-term physical morbidity. However, its chronic psychiatric sequelae remain poorly characterized. To investigate the prevalence of psychiatric symptoms, namely anxiety, depressive, and post-traumatic stress disorder (PTSD) symptoms after delirium, a systematic literature search of MEDLINE, EMBASE and PsycINFO databases was performed independently by two authors in March 2016. Bibliographies were hand-searched, and a forward- and backward-citation search using Web of Science was performed for all included studies...
January 27, 2017: Psychogeriatrics: the Official Journal of the Japanese Psychogeriatric Society
https://www.readbyqxmd.com/read/28067712/muscle-weakness-and-5-year-survival-in-acute-respiratory-distress-syndrome-survivors
#15
Victor D Dinglas, Lisa Aronson Friedman, Elizabeth Colantuoni, Pedro A Mendez-Tellez, Carl B Shanholtz, Nancy D Ciesla, Peter J Pronovost, Dale M Needham
OBJECTIVES: To longitudinally evaluate the association of post-ICU muscle weakness and associated trajectories of weakness over time with 5-year survival. DESIGN: Longitudinal prospective cohort study over 5 years of follow-up. SETTING: Thirteen ICUs in four hospitals in Baltimore, MD. PATIENTS: One hundred fifty-six acute respiratory distress syndrome survivors. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Strength was evaluated with standardized manual muscle testing using the Medical Research Council sum score (range, 0-60; higher is better), with post-ICU weakness defined as sum score less than 48...
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28045772/nutritional-practices-and-growth-in-premature-infants-after-surgical-necrotizing-enterocolitis
#16
Grace C Lin, Daniel T Robinson, Steven Olsen, Kristina M Reber, Mohannad Moallem, Robert DiGeronimo, Cecilia Mulroy, Ankur Datta, Karna Murthy
OBJECTIVE: To describe the nutritional provisions received by infants with surgical NEC and the associated effects on short-term growth. STUDY DESIGN: Through the Children's Hospitals Neonatal Database we identified infants born ≤32 weeks' gestation with surgical NEC from 5 regional neonatal intensive care units over 4 years. Excluded infants had isolated intestinal perforation and died <14 days post-operatively. Infants were stratified by their median parenteral protein dose (low (LP) or high (HP) protein) over the first post-operative week...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27923757/the-potentially-fatal-ogilvie-s-syndrome-in-lateral-transpsoas-access-surgery-a-multi-institutional-experience-with-2930-patients
#17
Jacob Januszewski, Sean K Keem, William Smith, Joshua M Beckman, Adam S Kanter, Rod J Oskuian, William Taylor, Juan S Uribe
BACKGROUND: Ogilvie's syndrome (OS) is a relatively uncommon pathology characterized by significant colonic dilation in the absence of mechanical obstruction. If unrecognized and untreated, cecal perforation resulting in a mortality rate of 25%-71% may occur. It is a potentially underdiagnosed condition in the lateral transpsoas approach population because of its uncommon nature and imitation of other well-known pathologies. METHODS: Two thousand nine hundred and thirty patients from 6 separate institutions were retrospectively reviewed since 2007 and screened for OS...
March 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27923754/successful-coil-embolization-of-pediatric-carotid-cavernous-fistula-due-to-ruptured-posttraumatic-giant-internal-carotid-artery-aneurysm
#18
Daisuke Wajima, Ichiro Nakagawa, Hun Soo Park, Shohei Yokoyama, Takeshi Wada, Kimihiko Kichikawa, Hiroyuki Nakase
BACKGROUND: The goal of the treatment of direct carotid cavernous fistula (CCF) is to occlude the arteriovenous shunt and to preserve the patency of the concerned internal carotid artery. However, for the ipsilateral posttraumatic fragile cerebrum, coil embolization plus parent artery occlusion for the high-flow direct CCF is better for the prevention of hyperperfusion syndrome and intracranial hemorrhage. We experienced such a case and managed it successfully. CASE DESCRIPTION: A 6-year-old boy had severe head trauma caused by being hit by a car...
February 2017: World Neurosurgery
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
#19
REVIEW
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/27903001/right-in-front-of-our-eyes-evolution-of-streptococcal-toxic-shock-syndrome-with-ischemic-optic-neuropathy
#20
Salaheldin M Elhamamsy, Mazen O Al-Qadi, Taro Minami, Marguerite Neill
INTRODUCTION: Toxic shock syndrome occurs from dysregulation of host inflammatory responses. Toxin- producing strains of Group A streptococcus cause TSS. Ischemic optic neuropathy rarely complicates septic shock. We present a rare case of streptococcal pharyngitis complicated by septic arthritis and TSS with reversible blindness due to non-arteritic ischemic optic neuropathy. CASE: A 28-year-old man drove to our ED with exudative pharyngitis. A rapid streptococcal test was positive...
December 1, 2016: Rhode Island Medical Journal
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