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Cardiovascular intensive care

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https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#1
Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida
PURPOSE: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications. METHODS: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started...
July 18, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28715077/age-and-gender-related-peculiarities-of-patients-with-delirium-in-the-cardiac-intensive-care-unit
#2
Pranas Serpytis, Petras Navickas, Alvydas Navickas, Rokas Serpytis, Giedrius Navickas, Sigita Glaveckaite
BACKGROUND: The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28713509/mechanical-ventilation-practice-in-egyptian-pediatric-intensive-care-units
#3
Bassant Salah Meligy, Sally Kamal, Seham Awad El Sherbini
INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28713255/the-impact-of-aerobic-exercise-on-fronto-parietal-network-connectivity-and-its-relation-to-mobility-an-exploratory-analysis-of-a-6-month-randomized-controlled-trial
#4
Chun L Hsu, John R Best, Shirley Wang, Michelle W Voss, Robin G Y Hsiung, Michelle Munkacsy, Winnie Cheung, Todd C Handy, Teresa Liu-Ambrose
Impaired mobility is a major concern for older adults and has significant consequences. While the widely accepted belief is that improved physical function underlies the effectiveness of targeted exercise training in improving mobility and reducing falls, recent evidence suggests cognitive and neural benefits gained through exercise may also play an important role in promoting mobility. However, the underlying neural mechanisms of this relationship are currently unclear. Thus, we hypothesize that 6 months of progressive aerobic exercise training would alter frontoparietal network (FPN) connectivity during a motor task among older adults with mild subcortical ischemic vascular cognitive impairment (SIVCI)-and exercise-induced changes in FPN connectivity would correlate with changes in mobility...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28711517/prevention-of-type-2-diabetes-mellitus-in-polycystic-ovary-syndrome-a-review
#5
REVIEW
Safa Anwar, Nigar Shikalgar
Polycystic ovary syndrome (PCOS) is recognized as one of the most common endocrinopathies in women of reproductive age, associated with metabolic sequelae which includes increased risk factors for impaired glucose tolerance (IGT), type 2 diabetes mellitus (DM2) and cardiovascular disease (CVD). The adverse effects of DM2 affects a woman throughout her lifespan. Health care expenditure of DM2 highlights the need for prevention through appropriate screening, diagnosis and intervention. Lifestyle modification (LSM) programs that include diet and/or physical activity are suggested for patients characterized as prediabetic to delay the onset of adult DM2...
July 8, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28708930/effects-of-high-intensity-aerobic-interval-training-on-cardiovascular-disease-risk-in-testicular-cancer-survivors-a-phase-2-randomized-controlled-trial
#6
Scott C Adams, Darren S DeLorey, Margie H Davenport, Michael K Stickland, Adrian S Fairey, Scott North, Alexander Szczotka, Kerry S Courneya
BACKGROUND: Testicular cancer survivors (TCS) have an increased risk of treatment-related cardiovascular disease (CVD), which may limit their overall survival. We evaluated the effects of high-intensity aerobic interval training (HIIT) on traditional and novel CVD risk factors and surrogate markers of mortality in a population-based sample of TCS. METHODS: This phase 2 trial (ClinicalTrials.gov identifier NCT02459132) randomly assigned 63 TCS to usual care (UC) or 12 weeks of supervised HIIT (ie, alternating periods of vigorous-intensity and light-intensity aerobic exercise)...
July 14, 2017: Cancer
https://www.readbyqxmd.com/read/28706103/vitamin-d-levels-in-critically-ill-patients-with-acute-kidney-injury-a-protocol-for-a-prospective-cohort-study-vid-aki
#7
Lynda Katherine Cameron, Katie Lei, Samantha Smith, Nanci Leigh Doyle, James F Doyle, Kate Flynn, Nicola Purchase, John Smith, Kathryn Chan, Farida Kamara, Nardos Ghebremedhin Kidane, Lui G Forni, Dominic Harrington, Geeta Hampson, Marlies Ostermann
INTRODUCTION: Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28705247/detecting-impaired-myocardial-relaxation-in-sepsis-with-a-novel-tissue-doppler-parameter-septal-e-s
#8
David J Clancy, Michel Slama, Stephen Huang, Timothy Scully, Anthony S McLean, Sam R Orde
BACKGROUND: Left ventricular diastolic dysfunction is associated with mortality outcomes in severe sepsis and septic shock. There are ongoing issues with diagnosing diastolic dysfunction in this cohort, partly owing to the poor applicability of traditional parameters in the hyperdynamic circulation. In this feasibility study, we sought to assess the utility of a novel parameter (septal e'/s') to identify diastolic dysfunction in patients with severe sepsis and septic shock who had normal systolic function against the 2016 American Society Echocardiography and European Association of Cardiovascular Imaging (ASE/EACI) guidelines on diastolic dysfunction...
July 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28704502/brain-natriuretic-peptide-bnp-may-play-a-major-role-in-risk-stratification-based-on-cerebral-oxygen-saturation-by-near-infrared-spectroscopy-in-patients-undergoing-major-cardiovascular-surgery
#9
Hiroshi Mukaida, Masakazu Hayashida, Satoshi Matsushita, Makiko Yamamoto, Atsushi Nakamura, Atsushi Amano
PURPOSE: A previous study reported that low baseline cerebral oxygen saturation (ScO2) (≤50%) measured with near-infrared spectroscopy was predictive of poor clinical outcomes after cardiac surgery. However, such findings have not been reconfirmed by others. We conducted the current study to evaluate whether the previous findings would be reproducible, and to explore mechanisms underlying the ScO2-based outcome prediction. METHODS: We retrospectively investigated 573 consecutive patients, aged 20 to 91 (mean ± standard deviation, 67...
2017: PloS One
https://www.readbyqxmd.com/read/28704250/abnormal-calcium-levels-during-trauma-resuscitation-are-associated-with-increased-mortality-increased-blood-product-use-and-greater-hospital-resource-consumption-a-pilot-investigation
#10
Emily J MacKay, Michael D Stubna, Daniel N Holena, Patrick M Reilly, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Jeremy W Cannon
BACKGROUND: Admission hypocalcemia predicts both massive transfusion and mortality in severely injured patients. However, the effect of calcium derangements during resuscitation remains unexplored. We hypothesize that any hypocalcemia or hypercalcemia (either primary or from overcorrection) in the first 24 hours after severe injury is associated with increased mortality. METHODS: All patients at our institution with massive transfusion protocol activation from January 2013 through December 2014 were identified...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28699492/adverse-drug-reactions-in-critical-care-setting-a-systematic-review
#11
Joshua Lisha, Velu Annalakshmi, Jose Maria, Devi Padmini
BACKGROUND: The prevalence of adverse drug reactions (ADRs) is reported to be high in critical care units. We conducted a systematic review to study the prevalence, drugs implicated, preventability, predictability, severity and determinants of ADRs in critical care settings. METHODS: We searched MEDLINE, EMBASE, PROQUEST and OVID (January 1995 to June 2015) using pre-specified appropriate medical subject heading (MeSH) terms. Of 1552 studies, 34 studies were included for data extraction and synthesis...
July 10, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28691497/increased-mortality-risk-in-diabetic-patients-discharged-from-hospital-with-insulin-therapy-after-an-acute-myocardial-infarction-data-from-the-fast-mi-2005-registry
#12
Vincent Bataille, Jean Ferrières, Nicolas Danchin, Etienne Puymirat, Marianne Zeller, Tabassome Simon, Didier Carrié
BACKGROUND: Merits of insulin use for diabetes treatment in patients with advanced atherosclerosis are debated. This observational study conducted in diabetic patients after an acute myocardial infarction aimed to assess whether insulin prescription at discharge (IPD) was related to all-cause mortality during follow-up. METHODS: Subjects were diabetic patients admitted in intensive- or coronary-care units for acute myocardial infarction (consecutively recruited in 223 centres in France) and discharged alive from the hospital, with or without an IPD...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28673901/implications-of-american-college-of-cardiology-american-heart-association-acc-aha-cholesterol-guidelines-on-statin-underutilization-for-prevention-of-cardiovascular-disease-in-diabetes-mellitus-among-several-us-networks-of-community-health-centers
#13
Ehimare Akhabue, Sarah S Rittner, Joseph E Carroll, Phillip M Crawford, Lydia Dant, Reesa Laws, Michael C Leo, Jon Puro, Stephen D Persell
BACKGROUND: Little is known about statin underutilization among diabetes mellitus patients cared for in community health centers, which tend to serve socioeconomically disadvantaged populations. Implications of the American College of Cardiology/American Heart Association (ACC/AHA) guidelines on preexisting gaps in statin treatment in this population are unclear. METHODS AND RESULTS: We included 32 440 adults (45% male, 63% nonwhite, 29% uninsured/Medicaid) aged 40 to 75 years with diabetes mellitus who received care within 16 community health center groups in 11 states in the Community Health Applied Research Network during 2013...
July 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28672079/acute-kidney-injury-in-congenital-cardiac-surgery-comparison-of-prifle-akin
#14
Murat Tanyildiz, Mesiha Ekim, Tanil Kendirli, Ercan Tutar, Zeynep Eyileten, Zeynep Birsin Ozcakar, Asli Kavaz, Fatos Yalcınkaya, Adnan Uysalel, Semra Atalay
BACKGROUND: Acute kidney injury (AKI) is associated with an increased risk of mortality especially in pediatric intensive care units. The aim of this study is to determine the risk factors of AKI in children undergoing cardiac surgery for congenital heart disease and compare two different classification systems: pRIFLE and AKIN. METHODS: We retrospectively analyzed 145 patient undergoing pediatric congenital heart surgery who were between 1 month and 18 years and treated by the cardiovascular surgery department from January 2009 to October 2011...
July 3, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28662606/patients-with-vasculitides-admitted-to-the-intensive-care-unit-implications-from-a-single-center-retrospective-study
#15
Yael Haviv, Ora Shovman, Nicola Luigi Bragazzi, Kassem Sharif, Yarden Yavne, Yehuda Shoenfeld, Howard Amital, Abdulla Watad
BACKGROUND: Vasculitides are a group of disorders characterized by inflammation of vessels. Vasculitides may have life-threatening complications with significant morbidity and mortality; however, information regarding the outcome and prognosis of patients with vasculitides requiring intensive care unit (ICU) is scarce. METHODS: Data of patients with vasculitides admitted to the ICU of the Sheba Medical Center between the years 2000 and 2014 were retrieved retrospectively...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28662238/use-of-audiometric-measurement-for-assessment-of-vocal-fold-function-in-postextubation-infants
#16
Yi-Chun Carol Liu, Indu Varier, Julina Ongkasuwan
Importance: Infants with vocal-fold motion impairment (VFMI) have an increased risk of aspiration and pulmonary complications. Flexible nasolaryngoscopy (FNL) is the gold standard for evaluation of vocal-fold mobility. Although safe, FNL causes measurable physiologic changes. Noxious stimuli, especially in neonates in the cardiovascular intensive care unit, may cause imbalance between the pulmonary and systemic circulations and potentially circulatory collapse. Objective: To examine whether bedside measurement of infant cry volume using a smartphone application can be a screening tool for vocal-fold movement in FNL...
June 29, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28647800/safety-and-effectiveness-of-tolvaptan-for-fluid-management-after-pediatric-cardiovascular-surgery
#17
Yuzo Katayama, Tsukasa Ozawa, Noritsugu Shiono, Hiroshi Masuhara, Takeshiro Fujii, Yoshinori Watanabe
BACKGROUND: Postoperative fluid management is important after open heart surgery, because cardiopulmonary bypass evokes an abnormal inflammatory response and increases vascular permeability, especially in pediatric patients. We assessed the safety and effectiveness of tolvaptan for management of postoperative fluid retention after congenital heart surgery. METHODS AND RESULTS: This retrospective study analyzed data from 43 children with uncomplicated congenital heart disease who underwent open heart surgery between September 2013 and August 2016...
June 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28643996/age-related-outcome-of-patients-after-traumatic-brain-injury-a-single-centre-observation
#18
Rolf Erlebach, Alberto Pagnamenta, Stephanie Klinzing, Federica Stretti, Silvia Cottini, Reto Schüpbach, Peter Steiger, Giovanna Brandi
BACKGROUND: Study-purpose is to analyze clinical features of patients with traumatic brain injury (TBI), their age-related outcomes and determinants of long- term outcome. METHODS: This retrospective cohort study was conducted in a level I University Swiss trauma center. Consecutive patients with moderate to severe TBI admitted for more than 48 hours to the Intensive Care Unit were included. Patients' and trauma characteristics, management during ICU-stay, prognostic scores and long- term outcomes were analyzed...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28641999/effect-of-pharmacist-care-on-medication-adherence-and-cardiovascular-outcomes-among-patients-post-acute-coronary-syndrome-a%C3%A2-systematic-review
#19
REVIEW
Maguy Saffouh El Hajj, Myriam Jihad Jaam, Ahmed Awaisu
BACKGROUND: The impact of collaborative and multidisciplinary health care on the outcomes of care in patients with acute coronary syndromes (ACS) is well-established in the literature. However, there is lack of high quality evidence on the role of pharmacist care in this setting. OBJECTIVE: This systematic review aimed to evaluate the impact of pharmacist care on patient outcomes (readmission, mortality, emergency visits, and medication adherence) in patients with ACS at or post-discharge...
June 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28641581/thyrotoxic-and-pheochromocytoma-multisystem-crisis-a-case-report
#20
Kodai Suzuki, Takahito Miyake, Hideshi Okada, Fuminori Yamaji, Yuichiro Kitagawa, Tetsuya Fukuta, Ryu Yasuda, Yoshihito Tanaka, Haruka Okamoto, Sho Nachi, Tomoaki Doi, Takahiro Yoshida, Keisuke Kumada, Shozo Yoshida, Hiroaki Ushikoshi, Izumi Toyoda, Shinji Ogura
BACKGROUND: Thyrotoxic crisis and pheochromocytoma multisystem crisis are rare, life-threatening, emergency endocrine diseases with various clinical manifestations. Here we report a case of a patient who simultaneously developed thyrotoxic crisis and pheochromocytoma multisystem crisis and required intensive cardiovascular management. CASE PRESENTATION: A 60-year-old Asian man experienced nausea and vomiting, and subsequently developed dyspnea and cold sweats while farming...
June 23, 2017: Journal of Medical Case Reports
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