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atrial fibrillation in icu

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https://www.readbyqxmd.com/read/29310559/arrhythmias-in-children-in-early-postoperative-period-after-cardiac-surgery
#1
Manoj Kumar Sahu, Anupam Das, Bharat Siddharth, Sachin Talwar, Sarvesh Pal Singh, Atul Abraham, Arin Choudhury
BACKGROUND: Postoperative arrhythmias are a known complication after cardiac surgical repairs for congenital heart disease. METHODS: Data were reviewed pertaining to incidence, diagnosis, potential risk factors, and management of postoperative arrhythmias in 369 consecutive patients under 18 years of age, undergoing elective open heart surgery. All children were admitted to the intensive care unit and continuous electrocardiographic monitoring was performed. Patient factors such as Aristotle Basic Complexity Score, total surgical duration, hypotension, tachycardia, serum lactate level, and inotropic score were analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29282098/the-impact-of-maintaining-serum-potassium-%C3%A2-3-6-meq-l-vs-%C3%A2-4-5-meq-l-on-the-incidence-of-new-onset-atrial-fibrillation-in-the-first-120-hours-after-isolated-elective-coronary-artery-bypass-grafting-study-protocol-for-a-randomised-feasibility-trial-for-the-proposed
#2
Niall G Campbell, Elizabeth Allen, Julie Sanders, Rebecca Swinson, Sophie Birch, Joanna Sturgess, Nawaf Al-Subaie, Diana Elbourne, Hugh Montgomery, Ben O'Brien
BACKGROUND: Atrial fibrillation (AF) occurs in approximately one in three patients after cardiac surgery, and is associated with increased short-term and long-term mortality, intensive care unit (ICU) and hospital stay, and increased cost of care. In an attempt to reduce AF incidence in these patients, serum potassium (K+) levels are commonly maintained at the high end of normal (4.5-5.5 mEq/L). However, such potassium supplementation is without proven benefit, and is not without negative consequences...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29276146/prognostic-impact-of-prolonged-cross-clamp-time-in-coronary-artery-bypass-grafting
#3
Vito G Ruggieri, Karl Bounader, Jean Philippe Verhoye, Francesco Onorati, Antonino S Rubino, Giuseppe Gatti, Tuomas Tauriainen, Marisa De Feo, Daniel Reichart, Magnus Dalén, Peter Svenarud, Giuseppe Faggian, Giuseppe Santarpino, Daniele Maselli, Riccardo Gherli, Giovanni Mariscalco, Antonio Salsano, Francesco Nicolini, Tiziano Gherli, Matteo Saccocci, Juhani K E Airaksinen, Sidney Chocron, Andrea Perrotti, Fausto Biancari
BACKGROUND: The prognostic impact of cross-clamp time (XCT) in patients undergoing isolated coronary artery bypass grafting (CABG) has not been thoroughly investigated. MATERIAL AND METHODS: 2957 patients who underwent on-pump isolated CABG from the prospective multicentre E-CABG study were the subjects of this analysis. RESULTS: The mean XCT in this series was 58±25minutes Cross-clamp time was >60 minutes in 1134 patients (38.3%), >75minutes in 619 patients (20...
October 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29258620/refractory-ventricular-fibrillations-after-surgical-repair-of-atrial-septal-defects-in-a-patient-with-cacna1c-gene-mutation-case-report
#4
Ai Kojima, Fumiaki Shikata, Toru Okamura, Takashi Higaki, Seiko Ohno, Minoru Horie, Shunji Uchita, Yujiro Kawanishi, Kenji Namiguchi, Takumi Yasugi, Hironori Izutani
BACKGROUND: Congenital long QT syndrome (LQTS) can cause ventricular arrhythmic events with syncope and sudden death resulting from malignant torsades de pointes (TdP) followed by ventricular fibrillations (VFs). However, the syndrome is often overlooked prior to the development of arrhythmic events in patients with congenital heart diseases demonstrating right bundle branch block on electrocardiogram (ECG). We present a case of an adult patient with congenital heart disease who developed VFs postoperatively, potentially due to his mutation in a LQTS related gene, which was not identified on preoperative assessment due to incomplete evaluation of his family history...
December 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29220756/the-impact-of-sustained-new-onset-atrial-fibrillation-on-mortality-and-stroke-incidence-in-critically-ill-patients-a-retrospective-cohort-study
#5
Takuo Yoshida, Shigehiko Uchino, Taisuke Yokota, Tomoko Fujii, Shoichi Uezono, Masanori Takinami
PURPOSE: The purpose of the study is to evaluate the impact of sustained new-onset AF on mortality and the incidence of stroke in critically ill non-cardiac surgery patients. MATERIAL AND METHODS: This was a retrospective cohort study of non-cardiac surgery patients with new-onset AF conducted in a general intensive care unit. We compared patients remaining in AF with those restored to sinus rhythm (SR) at 6h after the onset of AF and conducted multivariable logistic regression analysis for in-hospital mortality...
December 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29211225/off-pump-versus-on-pump-coronary-artery-bypass-grafting-in-frail-patients-study-protocol-for-the-fragile-multicenter-randomized-controlled-trial
#6
Omar Asdrúbal Vilca Mejía, Michel Pompeu Barros Oliveira Sá, Maurilio Onofre Deininger, Luís Roberto Palma Dallan, Rodrigo Coelho Segalote, Marco Antonio Praça de Oliveira, Fernando Antibas Atik, Magaly Arrais Dos Santos, Pedro Gabriel Melo de Barros E Silva, Rodrigo Mussi Milani, Alexandre Ciappina Hueb, Rosangela Monteiro, Ricardo Carvalho Lima, Luiz Augusto Ferreira Lisboa, Luís Alberto Oliveira Dallan, John Puskas, Fabio Biscegli Jatene
INTRODUCTION: Advances in modern medicine have led to people living longer and healthier lives. Frailty is an emerging concept in medicine yet to be explored as a risk factor in cardiac surgery. When it comes to CABG surgery, randomized controlled clinical trials have primarily focused on low-risk (ROOBY, CORONARY), elevated-risk (GOPCABE) or high-risk patients (BBS), but not on frail patients. Therefore, we believe that off-pump CABG could be an important technique in patients with limited functional capacity to respond to surgical stress...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29204771/comparison-of-blood-pressure-monitoring-by-applanation-tonometry-and-invasively-assessed-blood-pressure-in-cardiological-patients
#7
G Greiwe, S Hoffmann, L Herich, M S Winkler, C J Trepte, C R Behem, M Petzoldt, D A Reuter, S A Haas
The aim of this study was to evaluate the accuracy and precision of non-invasive continuous blood pressure measurement by applanation tonometry (AT) in awake or anaesthetised cardiological intensive care patients. Patients suffering from highly impaired left ventricular function atrial fibrillation or severe aortic valve stenosis were included into the study. Arterial blood pressure was recorded by applanation tonometry (T-Line 400, Tensys Medical®, USA) and an arterial line in awake or anaesthetised patients...
December 4, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29197340/clinical-significance-and-risk-factors-for-new-onset-and-recurring-atrial-fibrillation-following-cardiac-surgery-a-retrospective-data-analysis
#8
Hristo Todorov, Inka Janssen, Stefanie Honndorf, Daniela Bause, Antje Gottschalk, Silke Baasner, Thomas Volkert, Valentin Faerber, John F Stover, Martin Westphal, Björn Ellger
BACKGROUND: Although mortality after cardiac surgery has significantly decreased in the last decade, patients still experience clinically relevant postoperative complications. Among others, atrial fibrillation (AF) is a common consequence of cardiac surgery, which is associated with prolonged hospitalization and increased mortality. METHODS: We retrospectively analyzed data from patients who underwent coronary artery bypass grafting, valve surgery or a combination of both at the University Hospital Muenster between April 2014 and July 2015...
December 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29174777/cardiac-surgery-outcomes-in-abdominal-solid-organ-transplant-recipients
#9
Takushi Kohmoto, Satoru Osaki, Dixon B Kaufman, Glen Leverson, Nilto DeOliveira, Shahab A Akhter, Susan Ulschmid, Lucian Lozonschi, Entela B Lushaj
BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution. METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29173356/contrast-induced-nephropathy-after-cardiac-catheterization-culprits-consequences-and-predictors
#10
Yub Raj Sedhai, Reshma Golamari, Santosh Timalsina, Soney Basnyat, Ajay Koirala, Ankush Asija, Tatvam Choksi, Akanksha Kushwah, David Geovorgyan, Tawseef Dar, Madhura Borikar, Waseem Ahangar, Joseph Alukal, Subtain Zia, Jose Missri
BACKGROUND: Contrast-induced nephropathy (CIN) is a common complication after radiocontrast exposure. METHODS: A retrospective medical record review of 513 hospitalized patients who underwent cardiac catheterization from June-December 2014 was done, of which 38 patients with end-stage renal disease and 57 patients without preprocedural creatinine were excluded. Serum creatinine concentration before the procedure and each day for 3 days after the procedure was recorded...
November 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29128046/preoperative-anemia-in-cardiac-operation-does-hemoglobin-tell-the-whole-story
#11
Lu Dai, Stephanie L Mick, Keith R McCrae, Penny L Houghtaling, Joseph F Sabik, Eugene H Blackstone, Colleen G Koch
BACKGROUND: Preoperative anemia, defined by hemoglobin level, is associated with elevated risk after cardiac operation. Better understanding of anemia requires characterization beyond this. This investigation focuses on red cell size and its association with patient characteristics and outcomes after cardiac operation. METHODS: From January 2010 to January 2014, 10,589 patients underwent elective cardiac operations at Cleveland Clinic. Anemia was characterized as normocytic, microcytic, or macrocytic based on mean corpuscular volume (MCV)...
November 8, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29120136/postoperative-atrial-fibrillation-prophylaxis-and-lung-resection-%C3%A2-our-experience-with-608-consecutive-patients
#12
Vjekoslav Karadža, Dinko Stančić-Rokotov, Jasna Špiček Macan, Nevenka Hodoba, Nevenka Kolarić, Sanja Sakan
Postoperative atrial fibrillation is a common complication after lung resection. It is burdened by increased mortality and morbidity, prolonged hospitalization, and higher resource utilization in thoracic surgery patients. Therefore, some kind of pharmacological prophylaxis is recommended. In our patients, diltiazem, a calcium antagonist, is administered. We collected data on all 608 patients having undergone lung resection (no less than lobectomy) between November 2012 and May 2015. This period included patients having received diltiazem during their postoperative stay in our Intensive Care Unit and surgical ward, and those that did not receive it...
March 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29109881/hypothermia-with-extreme-bradycardia-following-spinal-cord-infarction-of-septic-origin
#13
Philippe Hantson, Thierry Duprez
Among other autonomic dysfunctions complicating acute spinal cord injury, deep hypothermia is rare but may induce serious cardiovascular complications. There are few pharmacological options to influence hypothermia. A 66-year-old woman was transferred to the intensive care unit (ICU) for serious cardiac arrhythmias (atrial fibrillation and asystole) in the context of a deep hypothermia (axillary temperature below 32°C). She had been admitted to the hospital two months before for an acute L4-L5 infectious spondylodiscitis without any initial neurological deficit...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29061465/isolated-and-concomitant-minimally-invasive-minithoracotomy-aortic-valve-surgery
#14
Joseph Lamelas, Maurice Mawad, Roy Williams, Ursula Keller Weiss, Qianzi Zhang, Angelo LaPietra
OBJECTIVE: To evaluate whether the outcomes of minimally invasive aortic valve surgery were similar in younger versus older patient groups, as well as whether concomitant minimally invasive aortic valve replacement (AVR) surgeries added significant risks in these populations. METHODS: We performed a single-institution retrospective analysis of 1018 patients undergoing isolated AVR and 378 patients undergoing concomitant AVR procedures over a 6-year period. All surgeries were via a right minithoracotomy approach, and patients who underwent reoperation were excluded...
September 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29049744/extended-pleurectomy-decortication-for-malignant-pleural-mesothelioma-in-the-elderly-the-need-for-an-inclusive-yet-selective-approach
#15
Annabel Jane Sharkey, Rocco Bilancia, Sara Tenconi, Apostolos Nakas, David A Waller
OBJECTIVES: The median age at diagnosis of patients with pleural mesothelioma in the UK is 73 years. Recent series have shown the feasibility of extended pleurectomy decortication in the elderly, but with continuing debate about the efficacy of this treatment, we reviewed our experience to identify more detailed selection criteria. METHODS: We reviewed prospectively collected data on all patients from 1999 to 2016 undergoing extended pleurectomy decortication...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049073/postoperative-outcomes-in-obstructive-sleep-apnea-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis-of-comparative-studies
#16
Mahesh Nagappa, George Ho, Jayadeep Patra, Jean Wong, Mandeep Singh, Roop Kaw, Davy Cheng, Frances Chung
BACKGROUND: Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. METHODS: A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29016380/comparison-of-del-nido-cardioplegia-with-blood-cardioplegia-in-adult-combined-surgery
#17
Raphael Hamad, Anthony Nguyen, Éric Laliberté, Denis Bouchard, Yoan Lamarche, Ismail El-Hamamsy, Philippe Demers
OBJECTIVE: del Nido solution (DNS) is a single-dose cardioplegia designed for pediatric use proposed to offer superior myocardial protection in adults. However, few data support this claim. We hypothesized that DNS and modified blood cardioplegia solution (BS) provide equivalent safety in combined adult valve surgery. METHODS: Between November 2014 and December 2015, 25 patients underwent primary aortic valve replacement and concomitant coronary artery bypass grafting (CABG) with DNS...
September 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28994674/relationship-between-perioperative-left-atrial-appendage-doppler-velocity-estimates-and-new-onset-atrial-fibrillation-in-patients-undergoing-coronary-artery-bypass-graft-surgery-with-cardiopulmonary-bypass
#18
Kunal Sarin, Sandeep Chauhan, Akshay K Bisoi, Poonam Malhotra Kapoor, Parag Gharde, Arindam Choudhury
BACKGROUND: Literature search reveals that postoperative atrial fibrillation (POAF) occurs in 15%-40% of coronary artery bypass graft (CABG) patients. Although several risk models exist for predicting the development of POAF, few have studied left atrial appendage (LAA) velocity. We hypothesize that an association between LAA velocity and development of POAF exists. DESIGN AND METHODS: Single institution university hospital prospective observational clinical study performed between May 2016 and November 2016 in 96 adult patients undergoing CABG surgery utilizing cardiopulmonary bypass (CPB)...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28992285/remote-ischaemic-preconditioning-for-renal-and-cardiac-protection-in-adult-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#19
Giacomo Deferrari, Alice Bonanni, Maurizio Bruschi, Cristiano Alicino, Alessio Signori
Background: The main aim of this systematic review was to assess whether remote ischaemic preconditioning (RIPC) protects kidneys and the heart in cardiac surgery with cardiopulmonary bypass (CPB) and to investigate a possible role of anaesthetic agents. Methods: Randomized clinical trials (RCTs) on the effects of RIPC through limb ischaemia in adult patients undergoing cardiac surgery with CPB were searched (1965-October 2016) in PubMed, Cochrane Library and article reference lists...
July 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28969751/pulmonary-venous-thromboembolism-in-an-acutely-ill-medical-patient-receiving-rivaroxaban
#20
Ayesha Saleem
Role of prophylactic anticoagulation in acutely ill medical patients has been extensively probed with the development of guidelines which made it convenient for the physicians to adopt a particular anticoagulation regimen for thromboprophylaxis. Intermingled with the guidelines are the development of modern anticoagulants like direct factor Xa inhibitors which are being studied for their role in the prevention of venous thromboembolism (VTE) in medically ill patients and have been concluded so far with the positive note...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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