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Cardiovascular intensive care

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https://www.readbyqxmd.com/read/29666901/subcutaneously-administered-dexmedetomidine-is-efficiently-absorbed-and-is-associated-with-attenuated-cardiovascular-effects-in-healthy-volunteers
#1
P Uusalo, D Al-Ramahi, I Tilli, R A Aantaa, M Scheinin, T I Saari
PURPOSE: Palliative care patients often need sedation to alleviate intractable anxiety, stress, and pain. Dexmedetomidine is used for sedation of intensive care patients, but there is no prior information on its subcutaneous (SC) administration, a route that would be favored in palliative care. We compared the pharmacokinetics and cardiovascular, sympatholytic, and sedative effects of SC and intravenously (IV) administered dexmedetomidine in healthy volunteers. METHODS: An open two-period, cross-over design with balanced randomization was used...
April 17, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29666844/burnout-among-anesthetists-and-intensive-care-physicians
#2
Audrius Mikalauskas, Rimantas Benetis, Edmundas Širvinskas, Judita Andrejaitienė, Šarūnas Kinduris, Andrius Macas, Žilvinas Padaiga
Burnout is a syndrome of depersonalization, emotional exhaustion, and low personal accomplishment. Little is known about burnout in physicians. Our objective was to determine the prevalence of burnout among anesthetists and intensive care physicians, and associations between burnout and personal, as well as professional, characteristics. Methods: In total, 220 anesthetists and intensive care physicians were contacted by email, asking them to participate in the study. For depression screening the PHQ-2 questionnaire, for problem drinking, CAGE items were used...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29664003/-pathogenesis-of-sepsis-induced-myocardial-dysfunction
#3
Yunpeng Lou, Zhaofen Lin
Sepsis is a common disease in intensive care units (ICU), and the resulted multi-organ dysfunction syndrome (MODS) is the main cause of death in patients with severe sepsis. The cardiovascular system is one of the most important target organ for sepsis. The severity of cardiac dysfunction is closely related to the clinical prognosis of patients with sepsis. Studies have reported that various cytokines are expressed during sepsis. They have influence on myocardial contractile function, mitochondrial function and self-regulation...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29663995/-risk-factors-of-atrial-fibrillation-in-critical-ill-patients
#4
Jianyu Fu, Hongying Bi, Yunsong Xia, Hui Fang, Xu Liu, Yan Tang, Difen Wang
OBJECTIVE: To observe the clinical features of atrial fibrillation (AF) patients, and to explore the correlation between the routine detection index and the new-onset AF and to find out risk factors for new AF in critically ill patients. METHODS: A prospective observational study was conducted. The patients with AF admitted to intensive care unit (ICU) of the Affiliated Hospital of Guizhou Medical University from March 2016 to June 2017 were enrolled. The patients were divided into new-onset AF group and past-existed AF group according to their past history of AF (including persistent AF, paroxysmal AF or permanent AF)...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29652753/hybrid-extracorporeal-therapies-as-a-bridge-to-pediatric-liver-transplantation
#5
Ayse Akcan Arikan, Poyyapakkam Srivaths, Ryan W Himes, Naile Tufan Pekkucuksen, Fong Lam, Trung Nguyen, Tamir Miloh, Michael Braun, John Goss, Moreshwar S Desai
OBJECTIVES: Standard intensive care treatment is inadequate to keep children with liver failure alive without catastrophic complications to ensure successful transplant, as accumulation of endogenous protein-bound toxins often lead to hepatic encephalopathy, hepatorenal syndrome, cardiovascular instability, and multiple organ failure. Given paucity of proven treatment modalities for liver failure, blood purification using different extracorporeal treatments as a bridge to transplantation is used, but studies evaluating the safety and efficacy of combination of these therapies, especially in pediatric liver failure, are lacking...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29652246/metformin-in-non-diabetic-hyperglycaemia-the-glint-feasibility-rct
#6
Simon J Griffin, M Angelyn Bethel, Rury R Holman, Kamlesh Khunti, Nicholas Wareham, Gwen Brierley, Melanie Davies, Andrew Dymond, Rose Eichenberger, Philip Evans, Alastair Gray, Colin Greaves, Kyla Harrington, Graham Hitman, Greg Irving, Sarah Lessels, Ann Millward, John R Petrie, Martin Rutter, Mike Sampson, Naveed Sattar, Stephen Sharp
BACKGROUND: The treatment of people with diabetes with metformin can reduce cardiovascular disease (CVD) and may reduce the risk of cancer. However, it is unknown whether or not metformin can reduce the risk of these outcomes in people with elevated blood glucose levels below the threshold for diabetes [i.e. non-diabetic hyperglycaemia (NDH)]. OBJECTIVE: To assess the feasibility of the Glucose Lowering In Non-diabetic hyperglycaemia Trial (GLINT) and to estimate the key parameters to inform the design of the full trial...
April 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29644444/-s3-guidelines-on-intensive-medical-care-of-cardiac-surgery-patients-hemodynamic-monitoring-and-cardiovascular-system-an-update
#7
REVIEW
M Habicher, T Zajonz, M Heringlake, A Böning, S Treskatsch, U Schirmer, A Markewitz, M Sander
An update of the S3- guidelines for treatment of cardiac surgery patients in the intensive care unit, hemodynamic monitoring and cardiovascular system was published by the Association of Scientific Medical Societies in Germany (AWMF) in January 2018. This publication updates the guidelines from 2006 and 2011. The guidelines include nine sections that in addition to different methods of hemodynamic monitoring also reviews the topic of volume therapy as well as vasoactive and inotropic drugs. Furthermore, the guidelines also define the goals for cardiovascular treatment...
April 11, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29643058/a-conceptual-framework-for-addressing-residual-atherosclerotic-cardiovascular-disease-risk-in-the-era-of-precision-medicine
#8
Kershaw V Patel, Ambarish Pandey, James A de Lemos
Until recently, therapies to mitigate atherosclerotic cardiovascular disease (ASCVD) risk have been limited to lifestyle interventions, blood pressure lowering medications, high intensity statin therapy, antiplatelet agents, and in select patients, coronary artery revascularization. Despite administration of these evidence-based therapies, substantial residual risk for cardiovascular events persists, particularly among individuals with known ASCVD. Moreover, the current guideline-based approach does not adequately account for patient-specific, causal pathways that lead to ASCVD progression and complications...
April 11, 2018: Circulation
https://www.readbyqxmd.com/read/29628837/factors-affecting-reintubations-after-cardiac-and-thoracic-surgeries-in-cardiac-intensive-care-unit-of-a-tertiary-care-hospital
#9
Khalid Maudood Siddiqui, Khalid Samad, Faisal Jonejo, Muhammad Faisal Khan, Khalid Ahsan
Background: Reintubation and readmission after cardiothoracic surgeries are not uncommon, and its reasons are multifactorial. The study goal was to identify the factors that contribute reintubation after cardiac and thoracic surgery in tertiary care hospital and to compare the outcome with international benchmark. Methodology: A prospective, observational study was planned in Cardiac Intensive Care Unit (CICU). The study included all those patients who required readmission in CICU due to endotracheal intubation following cardiac and thoracic surgeries...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29627994/the-prevalence-low-density-lipoprotein-cholesterol-levels-and-treatment-of-patients-at-very-high-risk-of-cardiovascular-events-in-the-united-kingdom-a-cross-sectional-study
#10
Mark D Danese, Eduard Sidelnikov, Lucie Kutikova
OBJECTIVE: To assess the prevalence of patients at very high risk of cardiovascular (CV) events in the United Kingdom (UK) and evaluate low-density lipoprotein cholesterol (LDL-C) values and treatment patterns in these patients. METHODS: This cross-sectional study used primary care data from UK electronic medical records in the Clinical Practice Research Datalink (CPRD) in 2013. Very high-risk patients were defined per European Society of Cardiology guidelines as those with hyperlipidemia (assessed by co-medication) and documented cardiovascular disease (CVD) or hyperlipidemia and type 2 diabetes (DM2) without CVD (DM2w/oCVD)...
April 9, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29624207/large-differences-in-neonatal-drug-use-between-nicus-are-common-practice-time-for-consensus
#11
R B Flint, F van Beek, P Andriessen, L Zimmermann, K D Liem, I K M Reiss, R de Groot, D Tibboel, D M Burger, S H P Simons
INTRODUCTION: Evidence for drug use in newborn is sparse, which may cause large differences in drug prescriptions. We aimed to investigate the differences between neonatal intensive care units (NICUs) in the Netherlands in currently prescribed drugs. MATERIALS AND METHODS: This multicenter study included neonates admitted during 12 months to four different NICUs. Drugs were classified in accordance with the Anatomical Therapeutic Chemical (ATC) classification system and assessed for on/off-label status in relation to neonatal age...
April 6, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29621235/survival-after-picu-admission-the-impact-of-multiple-admissions-and-complex-chronic-conditions
#12
Håkan Kalzén, Björn Larsson, Staffan Eksborg, Lars Lindberg, Karl Erik Edberg, Claes Frostell
OBJECTIVE: Factors predicting survival over time after pediatric intensive care unit (PICU) admissions are not fully understood. The primary aim of the current study was to investigate whether multiple admissions (MADM) compared to single PICU admissions (SADM) were associated with poor survival over time after being admitted to PICU facilities. Our secondary aim was to investigate if the presence of a complex chronic condition (CCC) would further impair prognosis. DESIGN: A closed cohort of all children up to 16 years of age admitted to the three PICUs in Sweden between 2008 and 2010 was prospectively collected and followed until 2012, providing survival data for at least one but up to four years of follow-up...
2018: PloS One
https://www.readbyqxmd.com/read/29621201/remote-ischemic-preconditioning-does-not-affect-the-release-of-humoral-factors-in-propofol-anesthetized-cardiac-surgery-patients-a-secondary-analysis-of-the-ripheart-study
#13
Julia Ney, Katleen Hoffmann, Patrick Meybohm, Andreas Goetzenich, Sandra Kraemer, Carina Benstöm, Nina C Weber, Johannes Bickenbach, Rolf Rossaint, Gernot Marx, Kai Zacharowski, Jürgen Bernhagen, Christian Stoppe
In contrast to several smaller studies, which demonstrate that remote ischemic preconditioning (RIPC) reduces myocardial injury in patients that undergo cardiovascular surgery, the RIPHeart study failed to demonstrate beneficial effects of troponin release and clinical outcome in propofol-anesthetized cardiac surgery patients. Therefore, we addressed the potential biochemical mechanisms triggered by RIPC. This is a predefined prospective sub-analysis of the randomized and controlled RIPHeart study in cardiac surgery patients ( n = 40) that was recently published...
April 5, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29618394/comparison-of-predictors-and-mortality-between-bloodstream-infections-caused-by-esbl-producing-escherichia-coli-and-esbl-producing-klebsiella-pneumoniae
#14
Oded Scheuerman, Vered Schechner, Yehuda Carmeli, Belen Gutiérrez-Gutiérrez, Esther Calbo, Benito Almirante, Pier-Luigy Viale, Antonio Oliver, Patricia Ruiz-Garbajosa, Oriol Gasch, Monica Gozalo, Johann Pitout, Murat Akova, Carmen Peña, Jose Molina, Alicia Hernández-Torres, Mario Venditti, Nuria Prim, Julia Origüen, German Bou, Evelina Tacconelli, Maria Tumbarello, Axel Hamprecht, Ilias Karaiskos, Cristina de la Calle, Federico Pérez, Mitchell J Schwaber, Joaquin Bermejo, Warren Lowman, Po-Ren Hsueh, Carolina Navarro-San Francisco, Robert A Bonomo, David L Paterson, Alvaro Pascual, Jesus Rodríguez-Baño
OBJECTIVETo compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypesMETHODSAs part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013...
April 5, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29616288/organ-support-therapy-in-the-intensive-care-unit-and-return-to-work-a-nationwide-register-based-cohort-study
#15
Signe Riddersholm, Steffen Christensen, Kristian Kragholm, Christian F Christiansen, Bodil Steen Rasmussen
PURPOSE: The association between severity of illness and ability to return to work is unclear. Therefore, we investigated return to work and associations with measures of illness severity in ICU survivors. METHODS: We conducted this cohort study using Danish registry data for the period 2005-2014 on ICU patients who were discharged alive from hospital, had an ICU length of stay (LOS) of at least 72 h, were not treated with dialysis before hospital admission and were working prior to admission...
April 3, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29614758/pediatric-age-palm-oil-consumption
#16
Lorenza Di Genova, Laura Cerquiglini, Laura Penta, Anna Biscarini, Susanna Esposito
Palm oil is widely used in the food industry for its chemical/physical properties, low cost and wide availability. Its widespread use has provoked an intense debate about whether it is a potential danger to human health. In a careful review of the scientific literature, we focused on nutritional characteristics and health effects of the use of palm oil with regards to children, seeking to determine whether there is evidence that justifies fears about the health effects of palm oil. Our review showed that palm oil represents a significant source of saturated fatty acids, to which scientific evidence attributes negative health effects when used in excess, especially with regards to cardiovascular diseases...
April 1, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29608503/risk-adjusted-overall-mortality-as-a-quality-measure-in-the-cardiovascular-intensive-care-unit
#17
Michael Goldfarb
Risk-adjusted mortality has been proposed as a quality of care indicator to gauge Cardiovascular Intensive Care Unit (CICU) performance. Mortality is easily measured, readily understandable, and a meaningful outcome for the patient, provider, administrative agencies, and other key stakeholders. Disease-specific risk-adjusted mortality is commonly used in cardiovascular medicine as an indicator of care quality, for external accreditation, and to determine payer reimbursement. However, the evidence base for overall risk-adjusted mortality in the CICU is limited, with most available data coming from the general critical care literature...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29602175/effect-of-anemia-on-prognosis-in-patients-on-extracorporeal-membrane-oxygenation
#18
Chang-Chyi Jenq, Feng-Chun Tsai, Tsung-Yu Tsai, Sue-Yun Hsieh, Yi-Wen Lai, Ya-Chung Tian, Ming-Yang Chang, Chan-Yu Lin, Ji-Tseng Fang, Chih-Wei Yang, Yung-Chang Chen
Anemia is a component of the pathological triangle in cardiorenal anemia syndrome and is a risk factor for mortality in acute respiratory distress syndrome. This study assessed the predictive value of anemia for outcomes in critically ill patients receiving extracorporeal membrane oxygenation (ECMO) support. This retrospective study analyzed patients who received ECMO support at the cardiovascular surgery intensive care unit in the study institute between July 2003 and March 2012. Patient data, such as demographic information, etiologies of ECMO implementation, clinical parameters, and in-hospital and 6-month mortality rates, were statistically analyzed...
March 30, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29601487/gene-therapeutic-strategies-targeting-angiogenesis-in-peripheral-artery-disease
#19
REVIEW
Fumihiro Sanada, Yoshiaki Taniyama, Jun Muratsu, Rei Otsu, Hideo Shimizu, Hiromi Rakugi, Ryuichi Morishita
The World Health Organization announced that cardiovascular disease is the number one cause of death globally, representing 31% of all global deaths. Coronary artery disease (CAD) affects approximately 5% of the US population aged 40 years and older. With an age-adjusted prevalence of approximately 12%, peripheral artery disease (PAD) affects at least 8 to 12 million Americans. Both CAD and PAD are caused by mainly atherosclerosis, the hardening and narrowing of arteries over the years by lipid deposition in the vascular bed...
March 30, 2018: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/29596292/informing-leadership-models-nursing-and-organizational-characteristics-of-neonatal-intensive-care-units-in-freestanding-children-s-hospitals
#20
Cheryl A Toole, Michele DeGrazia, Jean Anne Connor, Kimberlee Gauvreau, Hillary Bishop Kuzdeba, Patricia A Hickey
BACKGROUND: Neonatal intensive care units (NICUs) located in freestanding children's hospitals may exhibit significant variation in nursing and organizational characteristics, which can serve as opportunities for collaboration to understand optimal staffing models and linkages to patient outcomes. OBJECTIVES: Adopting methods used by Hickey et al in pediatric cardiovascular critical care, the purpose of this study was to provide a foundational description of the nursing and organizational characteristics for NICUs located in freestanding children's hospitals in the United States...
May 2018: Dimensions of Critical Care Nursing: DCCN
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