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atrial fibrillation in icu

Yu Liu, Jinsong Han, Tao Liu, Zhonglu Yang, Hui Jiang, Huishan Wang
Objective. To investigate the effects of diabetes mellitus (DM) in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Method. A total of 728 patients with DM and 1380 patients without DM who underwent OPCAB treatment from March 2012 to April 2015 were reviewed. The effects of DM on intraoperative variables and postoperative complications were determined using propensity score analysis. Results. Two well-matched subgroups were selected using propensity score analysis (DM = 728, no-DM = 728) to compare the perioperative outcome...
2016: BioMed Research International
Rakesh Naik, Gladdy George, Sathappan Karuppiah, Madhu Andrew Philip
OBJECTIVES OF THE STUDY: To identify the factors causing high lactate levels in patients undergoing cardiac surgery under cardiopulmonary bypass (CPB) and to assess the association between high blood lactate levels and postoperative morbidity and mortality. METHODS: A retrospective observational study including 370 patients who underwent cardiac surgeries under cardiopulmonary bypass. The patients were divided into 2 groups based on serum lactate levels; those with serum lactate levels greater than or equal to 4 mmol/L considered as hyperlactatemia and those with serum lactate levels less than 4 mmol/L...
October 2016: Annals of Cardiac Anaesthesia
Sevil Özkan, Fatih Özdemir, Oğuz Uğur, Refik Demirtunç, Ahmet Yavuz Balci, Mehmet Kizilay, Ünsal Vural, Mehmet Kaplan, Ibrahim Yekeler
BACKGROUND: The metabolic syndrome (MS) is a clustering of factors that are associated with increased cardiovascular risk. A low-grade inflammatory process acts as the underlying pathophysiology, which suggests that the MS may have a detrimental effect on coronary interventions, including coronary artery bypass grafting (CABG) surgery performed with cardiopulmonary bypass (CPB). We aimed to evaluate the effect of the MS on morbidity and mortality rates in the early postoperative period in patients undergoing CABG...
July 13, 2016: Cardiovascular Journal of Africa
Archana Hinduja, Kenneth Habetz, Sunil Kumar Raina, Ryan T Fitzgerald
Posterior reversible encephalopathy syndrome (PRES) is an acute neurological syndrome that requires prompt, aggressive management to improve outcomes. Our aim was to identify factors that would necessitate care in the intensive care unit (ICU) in patients with PRES and the outcomes on discharge following ICU stay. We retrospectively reviewed the medical records and radiological data of adult PRES patients admitted to our tertiary care medical center. We dichotomized them into two groups based on their need for ICU care and compared their clinical, laboratory, imaging characteristics and discharge outcomes...
September 28, 2016: Acta Neurologica Belgica
Ali Sait Kavakli, Nilgun Kavrut Ozturk, Raif Umut Ayoglu, Mustafa Emmiler, Lutfi Ozyurek, Kerem Inanoglu, Sadik Ozmen
OBJECTIVES: Various minimally invasive surgical approaches have been used in mitral valve (MV) surgery. The transapical off-pump mitral valve intervention with NeoChord implantation (TOP-MINI) is a minimally invasive, alternative procedure for the treatment of degenerative mitral regurgitation. There are several special considerations for the anesthesiologist during the TOP-MINI procedure. The main purpose of this study was to present the anesthetic management of the TOP-MINI procedure...
June 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Łukasz Lewicki, Janusz Siebert, Jan Rogowski
BACKGROUND: Postoperative atrial fibrillation (AF) is a common arrhythmia that occurs after coronary artery bypass grafting (CABG). New surgical techniques, particularly off-pump coronary artery bypass (OPCAB), are thought to be less invasive and results in fewer complications, i.e. AF, but available data are inconsistent. The aim of this study is to present the incidence and risk factors of AF in patients operated on with or without cardiopulmonary bypass. METHODS: We studied 1836 consecutive patients with stable coronary artery disease who were operated on with (CABG) or without (OPCAB) cardiopulmonary bypass...
September 26, 2016: Cardiology Journal
Tahar Chouihed, Stéphane Manzo-Silberman, Nicolas Peschanski, Sandrine Charpentier, Meyer Elbaz, Dominique Savary, Eric Bonnefoy-Cudraz, Said Laribi, Patrick Henry, Nicolas Girerd, Faiez Zannad, Carlos El Khoury
BACKGROUND: An appropriate diagnostic process is crucial for managing patients with acute heart failure (AHF) in emergency department (ED). Our study aims to describe the characteristics and therapeutic management of patients admitted to the ED for dyspnea suspected to have AHF, their in-hospital pathway of care and their in-hospital outcome. METHODS: Consecutive patients admitted in 26 French ED for dyspnea suspected to be the consequence of AHF, prior to in hospital diagnostic test, were prospectively included at the time of their admission in the DeFSSICA Survey...
September 17, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Perliveh Carrera, Charat Thongprayoon, Wisit Cheungpasitporn, Vivek N Iyer, Teng Moua
OBJECTIVE: To assess the incidence of new-onset atrial fibrillation (NOAF) in the medical intensive care unit setting and describe associated characteristics and implications for long-term outcomes. MATERIALS AND METHODS: A single-center, retrospective study of patients admitted to a medical intensive care unit from January 1, 2008, to December 31, 2013, was conducted. Atrial fibrillation (AF) diagnosis was categorized as NOAF or preexisting (PEAF). Intensive care unit characteristics along with in-hospital and long-term outcomes were compared...
July 9, 2016: Journal of Critical Care
Gudrun Dieberg, Neil A Smart, Nicola King
BACKGROUND: To reduce complications during coronary artery bypass grafting (CABG) off-pump CABG was introduced; however, results have been mixed. The aim of this work was to conduct a systematic review and meta-analysis of off-pump vs. on-pump CABG. METHODS: To identify potential studies systematic searches were carried out using various databases. The search strategy included the key concepts of "cardiopulmonary bypass" AND "coronary artery bypass grafting" AND "off pump"...
November 15, 2016: International Journal of Cardiology
Mattia Glauber, Simon C Moten, Eugenio Quaini, Marco Solinas, Thierry A Folliguet, Bart Meuris, Antonio Miceli, Peter J Oberwalder, Manfredo Rambaldini, Kevin H T Teoh, Gopal Bhatnagar, Michael A Borger, Denis Bouchard, Olivier Bouchot, Stephen C Clark, Otto E Dapunt, Matteo Ferrarini, Theodor J M Fischlein, Guenther Laufer, Carmelo Mignosa, Russell Millner, Philippe Noirhomme, Steffen Pfeiffer, Xavier Ruyra-Baliarda, Malakh Lal Shrestha, Rakesh M Suri, Giovanni Troise, Borut Gersak
OBJECTIVE: To define the benefit of sutureless and rapid deployment valves in current minimally invasive approaches in isolated aortic valve replacement. METHODS: A panel of 28 international experts with expertise in both minimally invasive aortic valve replacement and rapid deployment valves was constituted. After thorough literature review, the experts rated evidence-based recommendations in a modified Delphi approach. RESULTS: No guideline could be retrieved...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
M Halfon, G Wuerzner, P Marques-Vidal, J Vaucher, L Liaudet, B Waeber, G Waeber
OBJECTIVE: The measurement of blood pressure (BP) in atrial fibrillation (AF) is challenging and current guidelines recommend the use of the auscultatory method. The use of automated BP devices in AF is still debated. The objective was to analyze the reliability and the reproducibility of three different oscillometric BP devices in patients with AF and to assess the accuracy of two arm oscillometric BP devices in comparison with invasive blood pressure measurements (IBP). DESIGN AND METHOD: Forty-eight hospitalized patients with AF were randomized to undergo 10 consecutive BP measurements with either Omron R7™ (OR7, wrist) and HEM907™ (HEM, arm) or Omron R7™ and Watch BP home™ (WBP, arm)...
September 2016: Journal of Hypertension
H Lan, Y G Cheng, B C Jia, Y L Chai
OBJECTIVE: To summarize the clinical outcome of totally thoracoscopic cardiac surgery for mitral valve replacement. METHODS: Clinical data of 634 cases undergoing totally thoracoscopic cardiac surgery for mitral valve replacement from May 2004 to February 2016 in Department of Thoracoscopic Cardiacsurgery, Shanghai Yodak Cardiothoracic Hospital was analyzed retrospectively. There were 292 male and 342 female patients, aged from 17 to 68 years with a mean of (45±13) years...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Ahmed Almashrafi, Mustafa Elmontsri, Paul Aylin
BACKGROUND: Intensive care unit (ICU) care is associated with costly and often scarce resources. In many parts of the world, ICUs are being perceived as major bottlenecks limiting downstream services such as operating theatres. There are many clinical, surgical and contextual factors that influence length of stay. Knowing these factors can facilitate resource planning. However, the extent at which this knowledge is put into practice remains unclear. The aim of this systematic review was to identify factors that impact the duration of ICU stay after cardiac surgery and to explore evidence on the link between understanding these factors and patient and resource management...
2016: BMC Health Services Research
Peter M C Klein Klouwenberg, Jos F Frencken, Sanne Kuipers, David S Y Ong, Linda M Peelen, Lonneke A van Vught, Marcus J Schultz, Tom van der Poll, Marc J Bonten, Olaf L Cremer
RATIONALE: Patients admitted to intensive care units with sepsis are prone to developing cardiac dysrhythmias, most commonly atrial fibrillation. OBJECTIVES: We determined the incidence, risk factors and outcomes of atrial fibrillation in a cohort of critically ill patients with sepsis. METHODS: We assessed the association between atrial fibrillation and mortality using time-dependent competing risks survival analysis. Subsequently, for development of a risk score estimating the probability of a first occurrence of atrial fibrillation within the following 24 hours, we performed logistic regression analysis...
July 28, 2016: American Journal of Respiratory and Critical Care Medicine
Philip M Jones, Daniel Bainbridge, Michael W A Chu, Philip S Fernandes, Stephanie A Fox, Ivan Iglesias, Bob Kiaii, Ronit Lavi, John M Murkin
PURPOSE: Volatile anesthetics possess cardioprotective properties, but it is unknown if the cardioprotective effects extend equally to all members of the class. Although sevoflurane is a relatively newer anesthetic than isoflurane, its introduction into practice was not preceded by a head-to-head comparison with isoflurane in a trial focusing on clinically important outcomes. Our objective was to determine whether sevoflurane was non-inferior to isoflurane on a clinically important primary outcome in a heterogeneous group of adults undergoing cardiac surgery...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Mei Gao, Jianzhong Sun, Nilas Young, Douglas Boyd, Zane Atkins, Zhongmin Li, Qian Ding, James Diehl, Hong Liu
OBJECTIVES: Body mass index (BMI) commonly is used in obesity classification as a surrogate measure, and obesity is associated with a cluster of risk factors for cardiovascular disease. The aim of this study was to investigate the impact of BMI on short-term outcomes after cardiac surgery. DESIGN: A retrospective cohort study. SETTING: University teaching hospital, 2 centers. PARTICIPANTS: The study comprised 4,740 patients who underwent cardiac surgery at 2 hospitals-from July 1, 2001, to June 30, 2013, in 1 hospital and from September 1, 2003, to August 31, 2014, in a second hospital...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Jarosław Stoliński, Dariusz Plicner, Grzegorz Grudzień, Marcin Wąsowicz, Robert Musiał, Janusz Andres, Bogusław Kapelak
OBJECTIVE: The study objective was to compare aortic valve replacement through a right anterior minithoracotomy with aortic valve replacement through a median sternotomy. METHODS: With propensity score matching, we selected 211 patients after aortic valve replacement through a right anterior minithoracotomy and 211 patients after aortic valve replacement who underwent operation between January 2010 and December 2013. Perioperative outcomes were analyzed, and multivariable logistic regression analysis of risk factors of postoperative morbidity was performed...
October 2016: Journal of Thoracic and Cardiovascular Surgery
Ning Ding, Bu-Qing Ni, Hong Wang, Wen-Xiao Ding, Rong Xue, Wei Lin, Zhang Kai, Shi-Jiang Zhang, Xi-Long Zhang
STUDY OBJECTIVES: Sleep apnea is common in patients referred for cardiac valve replacement (CVR). We aimed to determine the association of obstructive sleep apnea (OSA) and central sleep apnea (CSA) with perioperative events in CVR surgery in patients with rheumatic valvular heart disease (RVHD). METHODS: Between April 2010 and April 2014, 290 patients with RVHD undergoing CVR were screened for sleep apnea 1 to 7 days before CVR. Baseline medications, cardiac function, sleep parameters, perioperative events, and related risk factors were evaluated...
July 19, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Naoki Hayase, Miyuki Yamamoto, Toshifumi Asada, Rei Isshiki, Naoki Yahagi, Kent Doi
BACKGROUND: Excessive sympathetic stress has multiple adverse effects during critical illness including sepsis. Recent studies showed that heart rate control had a significant effect on reducing mortality in septic shock patients. Furthermore, elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in septic patients were reportedly associated with adverse outcome. However, no study has evaluated the relationship between hemodynamic profiles of septic patients and the circulating cardiac biomarker...
July 1, 2016: Shock
Michael Mazzeffi, Samuel Galvagno, James S Gammie, Kenichi Tanaka
PURPOSE: Aspirin may prevent organ dysfunction in critically ill patients and mitigate transfusion associated acute lung injury. We hypothesized that aspirin use might be associated with decreased morbidity and mortality in massively transfused cardiac surgery patients. METHODS: A single center retrospective cohort study was performed using data from an 8.5-year period (2006-2014). Massive transfusion was defined as receiving at least 2400 ml (8 units) of red blood cell units intraoperatively...
October 2016: Journal of Anesthesia
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