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atrial fibrillation in icu

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https://www.readbyqxmd.com/read/28099179/traditional-sternotomy-versus-minimally-invasive-aortic-valve-replacement-in-patients-stratified-by-ejection-fraction
#1
Tom C Nguyen, Vinod H Thourani, Justin Q Pham, Yelin Zhao, Matthew D Terwelp, Prakash Balan, Daniel Ocazionez, Catalin Loghin, Richard W Smalling, Anthony L Estrera, Joseph Lamelas
OBJECTIVE: Low ejection fraction (EF < 40%) portends adverse outcomes in patients undergoing valvular heart surgery. The role of traditional median sternotomy aortic valve replacement (SAVR) compared with minimally invasive aortic valve replacement (MIAVR) in this cohort remains incompletely understood. METHODS: A multi-institutional retrospective review of 1503 patients who underwent SAVR (n = 815) and MIAVR via right anterior thoracotomy (n = 688) from 2011 to 2014 was performed...
January 17, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28076618/aortic-valve-replacement-treatment-by-sternotomy-versus-minimally-invasive-approach
#2
Renata Tosoni Rodrigues Ferreira, Roberto Rocha E Silva, Evaldo Marchi
Objective: To compare the results of aortic valve replacement with access by sternotomy or minimally invasive approach. Methods: Retrospective analysis of medical records of 37 patients undergoing aortic valve replacement by sternotomy or minimally invasive approach, with emphasis on the comparison of time of cardiopulmonary bypass and aortic clamping, volume of surgical bleeding, time of mechanical ventilation, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit, time of hospital discharge, short-term mortality and presence of surgical wound infection...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28045742/management-of-anticoagulation-with-rivaroxaban-in-trauma-and-acute-care-surgery-complications-and-reversal-strategies-as-compared-to-warfarin-therapy
#3
Sara P Myers, Esmaeel R Dadashzadeh, Jessica Cheung, Louis Alarcon, Matthew Kutcher, Joshua B Brown, Matthew D Neal
BACKGROUND: Rivaroxaban has gained popularity as an anticoagulant (AC) for stroke prevention in nonvalvular atrial fibrillation (afib) and venous thromboembolism (VTE). Although adverse bleeding events are associated with all AC, lack of point of care testing to measure the effect of rivaroxaban in emergent situations has contributed to perceived increased risk amongst physicians. METHODS: To describe a single center experience with trauma and emergency general surgery (EGS) patients taking rivaroxaban and evaluate outcomes compared with patients taking warfarin using a propensity score analysis...
December 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28000150/atrial-fibrillation-following-aortic-valve-replacement-impact-of-perioperative-use-of-intravenous-%C3%AE-blocker
#4
Junki Yokota, Hiroyuki Nishi, Naosumi Sekiya, Mitsutomo Yamada, Toshiki Takahashi
OBJECTIVES: Despite recent advances in perioperative management, postoperative atrial fibrillation/flutter (POAF) remains the most common complication after cardiac surgery. Therefore, it is important to determine related risk factors to establish effective management. However, most studies have focused on patients undergoing coronary artery bypass grafting and little is known about POAF in those who receive aortic valve replacement (AVR). We investigated the relationship of clinical predictors with POAF in patients undergoing AVR...
December 20, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27982112/usefulness-of-cha2ds2-vasc-scoring-systems-for-predicting-risk-of-perioperative-embolism-in-patients-of-cardiac-myxomas-underwent-surgical-treatment
#5
Liang Yin, Jing Wang, Wei Li, Xinyu Ling, Qian Xue, Yufeng Zhang, Zhinong Wang
Cardiac myxomas are rare but manifested with risk of embolism and often cause unexpected symptoms or sudden death. We retrospectively collected the medical records of patients diagnosed of cardiac myxomas at the cardiac center of our university. Overall 465 patients were included in this study, patients in the embolism group had significantly higher CHA2DS2-VASc scores (P = 0.005). In embolic group, stroke was recorded in 110 (77.14%) patients, while embolic events in the limbs were observed in 10 (2.15%) and 9(1...
December 16, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27965964/pulmonary-perfusion-and-ventilation-during-cardiopulmonary-bypass-are-not-associated-with-improved-postoperative-outcomes-after-cardiac-surgery
#6
Yiliam F Rodriguez-Blanco, Angela Gologorsky, Tomas Antonio Salerno, Kaming Lo, Edward Gologorsky
OBJECTIVES: Clinical trials of either pulmonary perfusion or ventilation during cardiopulmonary bypass (CBP) are equivocal. We hypothesized that to achieve significant improvement in outcomes both interventions had to be concurrent. DESIGN: Retrospective case-control study. SETTINGS: Major academic tertiary referral medical center. PARTICIPANTS: Two hundred seventy-four consecutive patients who underwent open heart surgery with CBP 2009-2013...
2016: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27956113/efficacy-and-safety-of-vitamin-c-for-atrial-fibrillation-after-cardiac-surgery-a-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#7
REVIEW
Xiaolan Hu, Linhui Yuan, Hongtao Wang, Chang Li, Junying Cai, Yanhui Hu, Changhua Ma
OBJECTIVES: Antioxidant supplement is an option in preventing postoperative atrial fibrillation (AF) after cardiac surgery. However, the benefits and adverse effects of vitamin C have not been well assessed. We aimed to systematically evaluate the efficacy and safety of vitamin C in preventing postoperative AF in adult patients after cardiac surgery. METHODS: PubMed, EMBASE, and the Cochrane library databases from inception to September 2016 were searched. Randomized controlled trials (RCTs) that evaluated the efficacy and safety of vitamin C in preventing postoperative AF in adult patients after cardiac surgery were identified...
January 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27936404/dexmedetomidine-vs-propofol-sedation-reduces-delirium-in-patients-after-cardiac-surgery-a-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#8
Xu Liu, Guohao Xie, Kai Zhang, Shengwen Song, Fang Song, Yue Jin, Xiangming Fang
PURPOSE: It is uncertain whether dexmedetomidine is better than propofol for sedation in postcardiac surgery patients. The purpose of this meta-analysis was to compare the effects of dexmedetomidine and propofol sedation on outcomes in adult patients after cardiac surgery. METHODS: Randomized controlled trials comparing outcomes in cardiac surgery patients sedated with dexmedetomidine or propofol were retrieved from PubMed, Embase, Web of Science, the Cochrane Library, and Clinicaltrials...
November 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27932513/improving-incidence-of-postoperative-atrial-fibrillation-after-cardiac-surgery-using-simplified-clinical-practice-guidelines
#9
Amr S Omar, Hesham Ewila, Mahmoud Allam, Sameh Aboulnagah, Samy Hanoura, Praveen C Sivadasan, Ousama Bilal, Abdul Rasheed A Pattath, Abdulaziz AlKhulaifi
OBJECTIVES: Postoperative atrial fibrillation (POAF) remains a major risk after cardiac surgery. Twelve percent patients admitted to this unit postcardiac surgery experienced POAF, which led to hemodynamic instability, increased risk of stroke, and increased length of postoperative intensive care unit stay. Our aim was to decrease the incidence of POAF in the cardiothoracic intensive care unit by the end of April 2014. METHODS: Design-Retrospective data analysis...
December 8, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27914358/defining-the-role-of-perioperative-statin-treatment-in-patients-after-cardiac-surgery-a-meta-analysis-and-systematic-review-of-20-randomized-controlled-trials
#10
Xin Yuan, Jianlin Du, Qi Liu, Ling Zhang
BACKGROUND: Although statin use has been indicated to prevent atrial fibrillation in previous observational and experimental trials, the issue remains inadequately and insufficiently explored. We therefore performed this meta-analysis to evaluate the effects of perioperative statin therapy on complications and short-term prognosis following cardiac surgery. METHODS: A search of the PubMed, EMBASE and the Cochrane database of controlled trials was performed from inception to June 2016 to identify relevant randomized controlled trials (RCTs)...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27858375/diagnosis-of-non-occlusive-acute-mesenteric-ischemia-in-the-intensive-care-unit
#11
Simon Bourcier, Ammar Oudjit, Geoffrey Goudard, Julien Charpentier, Sarah Leblanc, Romain Coriat, Hervé Gouya, Bertrand Dousset, Jean-Paul Mira, Frédéric Pène
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is a common complication and accounts for a major cause of death in critically ill patients. The diagnosis of NOMI with respect to the eventual indications for surgical treatment is challenging. We addressed the performance of the diagnostic strategy of NOMI in the intensive care unit, with emphasis on contrast-enhanced abdominal CT-scan. METHODS: This was a retrospective monocenter study. Patients with clinically suspected acute mesenteric ischemia were included if a comprehensive diagnostic workup was carried out including surgical and/or endoscopic digestive explorations...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27855722/prognostic-impact-of-restored-sinus-rhythm-in-patients-with-sepsis-and-new-onset-atrial-fibrillation
#12
Wen Cheng Liu, Wen Yu Lin, Chin Sheng Lin, Han Bin Huang, Tzu Chiao Lin, Shu Meng Cheng, Shih Ping Yang, Jung Chung Lin, Wei Shiang Lin
BACKGROUND: New-onset atrial fibrillation (NeOAF) is a common type of tachyarrhythmia in critically ill patients and is associated with increased mortality in patients with sepsis. However, the prognostic impact of restored sinus rhythm (SR) in septic patients with NeOAF remains unclear. METHODS: A total of 791 patients with sepsis, who were admitted to a medical intensive care unit from January 2011 to January 2014, were screened. NeOAF was detected by continuous electrocardiographic monitoring...
November 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27826974/can-n-terminal-pro-b-type-natriuretic-peptide-neutrophil-to-lymphocyte-ratio-c-reactive-protein-help-to-predict-short-and-long-term-mortality
#13
I Ozmen, Z Karakurt, C Salturk, F Kargin, H B Takir, E Aksoy, R Sari, E Celik, E A Tuncay, E Yildirim, O Y Mocin, N Adiguzel, S Oztas, S Gungor, G Gungor
BACKGROUND: There is limited data about ICU, short and long-term mortality prediction of severe CAP with neutrophil-to-lymphocyte ratio (NLR): N-terminal proB- type natriuretic peptide (NT-proBNP): C-reactive protein (CRP). AIM: Besides the known severity indexes of ICU, can NLR, NT-proBNP, CRP predict ICU, short and long term mortality? METHODS: A retrospective cohort study was carried out in a level III ICU of a tertiary training hospital for chest diseases and thoracic surgery...
2016: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/27806938/meta-analysis-of-ascorbic-acid-for-prevention-of-postoperative-atrial-fibrillation-after-cardiac-surgery
#14
William L Baker, Craig I Coleman
PURPOSE: Results of a systematic review and meta-analysis of published data on use of ascorbic acid to prevent postoperative atrial fibrillation (POAF) after cardiac surgery are presented. METHODS: MEDLINE and other sources were searched for reports on trials evaluating the effects of preoperative and/or postoperative use of ascorbic acid in patients undergoing cardiac surgery. For each study selected for meta-analysis, an assessment for risks of methodological bias was performed...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27803496/left-atrial-to-esophageal-fistula-a-case-report-and-literature-review
#15
Muhammad Yasir Khan, Waqas Javed Siddiqui, Praneet S Iyer, Ahmed Dirweesh, Nigahus Karabulut
BACKGROUND Left atrial to esophageal fistula (LAEF) is a rare fatal complication of radiofrequency ablation (RFA) for atrial fibrillation and is associated with high mortality. Clinical features can be nonspecific and include fever, dysphagia, upper gastrointestinal (GI) bleeding, sepsis, and embolic stroke a after recent history of RFA for atrial fibrillation. CASE REPORT  A 57-year-old Caucasian male was brought to the emergency department (ED) by his family because of an altered mental status. He had undergone a radiofrequency ablation for paroxysmal atrial fibrillation three weeks earlier...
November 2, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27777946/the-effects-of-diabetes-mellitus-in-patients-undergoing-off-pump-coronary-artery-bypass-grafting
#16
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
https://www.readbyqxmd.com/read/27716698/hyperlactatemia-in-patients-undergoing-adult-cardiac-surgery-under-cardiopulmonary-bypass-causative-factors-and-its-effect-on-surgical-outcome
#17
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
https://www.readbyqxmd.com/read/27701481/the-effects-of-the-metabolic-syndrome-on-coronary-artery-bypass-grafting-surgery
#18
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
https://www.readbyqxmd.com/read/27680733/predictors-of-intensive-care-unit-utilization-in-patients-with-posterior-reversible-encephalopathy-syndrome
#19
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
https://www.readbyqxmd.com/read/27671218/anesthetic-management-of-transapical-off-pump-mitral-valve-repair-with-neochord-implantation
#20
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...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
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