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atrial fibrillation in icu

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https://www.readbyqxmd.com/read/28932497/evaluation-of-amiodarone-versus-metoprolol-in-treating-atrial-fibrillation-after-coronary-artery-bypass-grafting
#1
Alireza Kamali, Amir Sanatkar, Mehrzad Sharifi, Esmaeil Moshir
INTRODUCTION: Atrial fibrillation (AF) is the most common arrhythmia affecting patients in open heart ICU after coronary artery bypass grafting (CABG). Most cardiac surgery textbooks recommend beta blockers as the drug of choice for treating such a condition while many experienced physicians and a number of anesthesiology references offer amiodarone as the drug of choice. Therefore, because of insufficient evidence and the aforementioned controversy, we decided to conduct a study evaluating these two antiarrhythmic medicines...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28929012/current-practice-in-the-management-of-new-onset-atrial-fibrillation-in-critically-ill-patients-a-uk-wide-survey
#2
Chung Shen Chean, Daniel McAuley, Anthony Gordon, Ingeborg Dorothea Welters
BACKGROUND: New-onset atrial fibrillation (AF) is the most common arrhythmia in critically ill patients. Although evidence base and expert consensus opinion for management have been summarised in several international guidelines, no specific considerations for critically ill patients have been included. We aimed to establish current practice of management of critically ill patients with new-onset AF. METHODS: We designed a short user-friendly online questionnaire...
2017: PeerJ
https://www.readbyqxmd.com/read/28882638/delayed-onset-of-atrial-fibrillation-and-ventricular-tachycardia-after-an-automobile-lightning-strike
#3
Dorian Drigalla, Shannon E Essler, C Keith Stone
BACKGROUND: Lightning strike is a rare medical emergency. The primary cause of death in lightning strike victims is immediate cardiac arrest. The mortality rate from lightning exposure can be as high as 30%, with up to 70% of patients left with significant morbidity. CASE REPORT: An 86-year-old male was struck by lightning while driving his vehicle and crashed. On initial emergency medical services evaluation, he was asymptomatic with normal vital signs. During his transport, he lost consciousness several times and was found to be in atrial fibrillation with intermittent runs of ventricular tachycardia during the unconscious periods...
September 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28863040/del-nido-cardioplegia-for-myocardial-protection-in-adult-cardiac-surgery-a-systematic-review-and-meta-analysis
#4
Yongnan Li, Hao Lin, Yinglu Zhao, Zhenzhen Li, Debin Liu, Xiangyang Wu, Bingyang Ji, Bingren Gao
Cardioplegia is an important strategy for myocardial protection during cardiac surgery. This meta-analysis was to compare the effects of del Nido and conventional cardioplegia in adult patients. Systematic searches were performed to identify studies using PubMed, Embase, the Cochrane Library, and the International Clinical Trials Registry Platform. A total of nine studies were included. Cardiopulmonary bypass and cross-clamp time were significantly shorter in the del Nido than conventional cardioplegia (mean difference [MD]: -7...
August 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28857800/outcomes-in-patients-undergoing-cardiac-surgery-who-decline-transfusion-and-received-erythropoietin-compared-to-patients-who-did-not-a-matched-cohort-study
#5
Lorent Duce, Mary L Cooter, Sharon L McCartney, Frederick W Lombard, Nicole R Guinn
BACKGROUND: Erythropoiesis-stimulating agents, such as erythropoietin (EPO), can be used to treat preoperative anemia. Some studies suggest an increased risk of mortality and thrombotic events, and use in cardiovascular surgery remains off-label. This study compares outcomes in cardiac surgery patients declining blood transfusion who received EPO with a matched cohort who did not. METHODS: After institutional review board approval, we conducted a retrospective review of all patients who decline blood transfusion who underwent cardiac surgery and received EPO between January 1, 2004, and June 15, 2015, at a single institution...
August 29, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28854537/prognostic-significance-of-central-venous-to-arterial-carbon-dioxide-difference-during-the-first-24-hours-of-septic-shock-in-patients-with-and-without-impaired-cardiac-function
#6
G Muller, E Mercier, P Vignon, M Henry-Lagarrigue, T Kamel, A Desachy, V Botoc, G Plantefève, J P Frat, F Bellec, J P Quenot, P F Dequin, T Boulain
Objective: To investigate the prognostic significance of central venous-to-arterial carbon dioxide difference (cv-art CO 2 gap) during septic shock in patients with and without impaired cardiac function. Methods: We performed a prospective cohort study in 10 French intensive care units. Patients suffering from septic shock were assigned to the impaired cardiac function group ('cardiac group', n =123) if they had atrial fibrillation (AF) and/or left ventricular ejection fraction (LVEF) <50% at study entry and to the non-cardiac group ( n =240) otherwise...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28851605/new-onset-atrial-fibrillation-and-clinical-outcome-in-non-cardiac-intensive-care-unit-patients
#7
Stamatis S Makrygiannis, Despina Rizikou, Nikolaos G Patsourakos, Manolis Lampakis, Anastasia Margariti, Olga S Ampartzidou, Konstantinos Sakellaridis, Paraskevi Tselioti, Athanasios Pipilis, Athanasios A Prekates
BACKGROUND: Data regarding new onset atrial fibrillation (nAF) in general, non-cardiac, intensive care unit (ICU) patients are limited. However, it has been suggested that nAF is associated with worse clinical outcome in these patients. OBJECTIVE: The purpose of the present work was to study the prognostic impact of nAF, in this setting. METHODS: We prospectively studied all patients admitted to a single ICU for a period of 12 months. Patients admitted for brief post-operative monitoring, patients with chronic, intermittent atrial fibrillation and atrial fibrillation present upon admission, were excluded...
August 26, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28820543/minimally-invasive-versus-transcatheter-and-surgical-aortic-valve-replacement-a-propensity-matched-study
#8
Matthew D Terwelp, Vinod H Thourani, Yelin Zhao, Prakash Balan, Catalin Loghin, Daniel Ocazionez, Anthony Estrera, Carson T Hoffmann, Vasilis C Babaliaros, Joseph Lamelas, Tom C Nguyen
BACKGROUND: An increasing number of options exist for the treatment of severe symptomatic aortic stenosis. The study aim was to compare short-term outcomes in patients undergoing surgical aortic valve replacement (SAVR), minimally invasive aortic valve replacement (MIAVR), and transcatheter aortic valve replacement (TAVR). METHODS: A multi-institutional retrospective review of 2,571 patients undergoing SAVR (n = 842), MIAVR via right anterior thoracotomy (n = 699) and TAVR (n = 1,030) between 2011 and 2014 was conducted...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28741665/remote-ischemic-preconditioning-and-clinical-outcomes-in-on-pump-coronary-artery-bypass-grafting-a-meta-analysis-of-14-randomized-controlled-trials
#9
Bin Yi, Jianhui Wang, Dingwu Yi, Yanling Zhu, Yumei Jiang, Yi Li, Shaoyan Mo, Yi Liu, Jian Rong
The purpose of this article is to perform the first pooled analysis on remote ischemic preconditioning (RIPC) used for the improvement of clinical outcomes of patients only undergoing on-pump coronary artery bypass grafting (CABG) in randomized controlled trials (RCTs). A systematic search was performed using PubMed, the Cochrane Library, and the Web of Science to identify studies that described the effect of RIPC on postoperative mortality in patients only undergoing on-pump CABG. The outcomes included postoperative mortality, postoperative morbidity (including incidence of myocardial infarction, atrial fibrillation, stroke, acute kidney injury, and renal replacement therapy), mechanical ventilation (MV), intensive care unit length of stay (ICU LOS), and hospital length of stay (HLOS)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28740714/aortic-valve-replacement-in-patients-with-a-left-ventricular-ejection-fraction-%C3%A2-35-performed-via-a-minimally-invasive-right-thoracotomy
#10
Orlando Santana, Steve Xydas, Roy F Williams, Angelo La Pietra, Maurice Mawad, Vicente Behrens, Esteban Escolar, Christos G Mihos
BACKGROUND: We evaluated the outcomes of patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35% who underwent minimally invasive aortic valve replacement (AVR), with or without concomitant mitral valve (MV) surgery. METHODS: All minimally invasive AVR in patients with a left ventricular ejection fraction ≤35%, performed via a right thoracotomy for aortic stenosis or regurgitation between January 2009 and March 2013, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28732315/total-and-ionized-magnesium-testing-in-the-surgical-intensive-care-unit-opportunities-for-improved-laboratory-and-pharmacy-utilization
#11
Daniel Dante Yeh, Nalin Chokengarmwong, Yuchiao Chang, Liyang Yu, Colleen Arsenault, Joseph Rudolf, Elizabeth Lee-Lewandrowski, Kent Lewandrowski
PURPOSE: Ionized fraction (iMg) is the physiologically active form of magnesium (Mg); total Mg may not accurately reflect iMg status. Erroneously "low" Mg levels may result in unnecessary repetitive testing. MATERIALS AND METHODS: From 11/2015 to 01/2016, patients ordered for Mg from a pilot ICU also had iMg tested. Weighted kappa statistic was used to assess agreement between Mg categories (low, normal, high). Predictors of unnecessary repeated Mg testing and repletion using data were explored through logistic regression models using GEE techniques to account for repeated measurements in both bivariate and multivariable analyses...
July 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28721223/atrial-fibrillation-in-a-preterm-newborn-with-structurally-normal-heart
#12
Pier Paolo Bassareo, Andrea Raffaele Marras, Mariangela Marras, Silvia Marras, Giuseppe Mercuro
Atrial fibrillation (AF) is a really uncommon arrhythmia in newborns. Here, we report the case of a 1-day-old infant who was recovered in Neonatal Intensive Care Unit for a twin-to-twin transfusion. The appearance of an unexpected AF was registered at his continuous electrocardiographic monitoring. Both chest X-ray and echocardiographic examination revealed the anomalous insertion of the tip of a central venous catheter (CVC) into the heart ('umbilical artery → inferior vena cava → right atrium → patent foramen ovale → left atrium')...
March 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28717057/glucose-variability-based-on-continuous-glucose-monitoring-assessment-is-associated-with-postoperative-complications-after-cardiovascular-surgery
#13
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/28702263/factors-associated-with-the-incidence-and-severity-of-new-onset-atrial-fibrillation-in-adult-critically-ill-patients
#14
Péricles A D Duarte, Gustavo Elias Leichtweis, Luiza Andriolo, Yasmim A Delevatti, Amaury C Jorge, Andreia C Fumagalli, Luiz Claudio Santos, Cecilia K Miura, Sergio K Saito
BACKGROUND: Acute Atrial Fibrillation (AF) is common in critically ill patients, with significant morbidity and mortality; however, its incidence and severity in Intensive Care Units (ICUs) from low-income countries are poorly studied. Additionally, impact of vasoactive drugs on its incidence and severity is still not understood. This study aimed to assess epidemiology and risk factors for acute new-onset AF in critically ill adult patients and the role of vasoactive drugs. METHOD: Cohort performed in seven general ICUs (including cardiac surgery) in three cities in Paraná State (southern Brazil) for 45 days...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28673707/predictors-of-survival-functional-survival-and-hospital-readmission-in-octogenarians-after-surgical-aortic-valve-replacement
#15
Kendra Kuo, Pallav Shah, Brett Hiebert, Karin Love, Alan H Menkis, Rizwan A Manji, Rakesh C Arora
OBJECTIVE: To analyze outcomes and predictors of functional survival (personal care home admission and mortality) and hospital readmission in patients aged ≥80 years who underwent surgical aortic valve replacement (SAVR) in a Manitoba hospital. METHODS: This was a retrospective cohort study of patients aged ≥80 years who underwent SAVR with or without coronary artery bypass grafting in Manitoba between 1995 and 2014. Data from the Manitoba Adult Cardiac Surgery database and the Manitoba Centre for Health Policy were used...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28645181/the-clinical-benefits-of-perioperative-antioxidant-vitamin-therapy-in-patients-undergoing-cardiac-surgery-a-meta-analysis
#16
Jun Geng, Ju Qian, Weijun Si, Hao Cheng, Fuhai Ji, Zhenya Shen
The clinical benefits of perioperative antioxidant vitamin therapy in cardiac patients remain controversial. Here, we conducted a meta-analysis to determine the strength of the evidence supporting the perioperative use of antioxidant vitamins in patients undergoing cardiac surgery. We searched 4 databases (PubMed, EMBASE, Science Citation Index and Cochrane Library) for randomized controlled trials that reported the effects of antioxidant vitamin therapy on patients undergoing cardiac surgery until 6 June 2016...
June 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28583297/the-cox-maze-iv-procedure-for-atrial-fibrillation-is-equally-efficacious-in-patients-with-rheumatic-and-degenerative-mitral-valve-disease
#17
Jonathan E Labin, Nowrin Haque, Laurie A Sinn, Richard B Schuessler, Marc R Moon, Hersh S Maniar, Spencer J Melby, Ralph J Damiano
OBJECTIVE: To determine whether the etiology of mitral valve disease (MVD), due to either rheumatic or degenerative pathology, influences long-term outcomes after the Cox-Maze IV procedure (CMPIV). METHODS: Between February 2001 and July 2015, 245 patients received a CMIV and concomitant mitral valve procedure. Patients were separated into 2 cohorts based on their etiology of MVD, degenerative (n = 153) and rheumatic (n = 92). Patients were followed prospectively (mean follow-up: 41 ± 37 months) for recurrent atrial tachyarrhythmias (ATAs)...
September 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28580563/-new-treatment-for-vascular-thrombosis-prevention-in-patients-with-atrial-fibrillation-left-atrial-appendage-occlusion
#18
Chen-Wei Lin, Shiao-Pei Wang
Atrial fibrillation (AF) is a common type of arrhythmia that increases significantly the risk of blood clots in the heart and of stroke. Therefore, stroke prevention is a key goal of AF treatment. In the past, patients were required to take anticoagulants for the remainder of their life, to regularly the monitor international normalized ratio (INR) of prothrombin time (PT), and to avoid possible negative interactions with various drugs and foods. Left atrial appendage occlusion (LAAO), a novel device and technique, was thus developed for AF patients with contraindications to anticoagulants and a high risk of bleeding...
June 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28579349/electromagnetic-guided-placement-of-nasoduodenal-feeding%C3%A2-tubes-versus-endoscopic-placement-a-randomized-multicenter-trial
#19
Wouter F W Kappelle, Daisy Walter, Paul H Stadhouders, Hendrik J A Jebbink, Frank P Vleggaar, Peter J van der Schaar, Jan Willem Kappelle, Ingeborg van der Tweel, Medard F M Van den Broek, Frank J Wessels, Peter D Siersema, Jan F Monkelbaan
BACKGROUND AND AIMS: Electromagnetic-guided placement (EMP) of a nasoduodenal feeding tube by trained nurses is an attractive alternative to EGD-guided placement (EGDP). We aimed to compare EMP and EGDP in outpatients, ward patients, and critically ill patients with normal upper GI anatomy. METHODS: In 3 centers with no prior experience in EMP, patients were randomized to placement of a single-lumen nasoduodenal feeding tube either with EGDP or EMP. The primary endpoint was post-pyloric position of the tube on abdominal radiography...
June 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28552276/adjuncts-to-blood-component-therapies-for-the-treatment-of-bleeding-in-the-intensive-care-unit
#20
REVIEW
Jerrold H Levy, Kamrouz Ghadimi, Quintin J Quinones, Raquel R Bartz, Ian Welsby
Patients who are critically ill following surgical or traumatic injury often present with coagulopathy as a component of the complex multisystem dysfunction that clinicians must rapidly diagnose and treat in the intensive care environment. Failure to recognize coagulopathy while volume resuscitation with crystalloid or colloid takes place, or an unbalanced transfusion strategy focused on packed red blood cell transfusion can all significantly worsen coagulopathy, leading to increased transfusion requirements and poor outcomes...
April 25, 2017: Transfusion Medicine Reviews
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