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Paul Elbers, Tim Rodrigus, Esther Nossent, Manu L N G Malbrain, Anton Vonk-Noordegraaf
As right heart function can affect outcome in the critically ill patient, a thorough understanding of factors determining right heart performance in health and disease is pivotal for the critical care physician. This review focuses on fluid therapy, which remains controversial in the setting of impending or overt right heart failure. In this context, we will attempt to elucidate which patients are likely to benefit from fluid administration and for which patients fluid therapy would likely be harmful. Following a general discussion of right heart function and failure, we specifically focus on important causes of right heart failure in the critically ill, i...
2015: Anaesthesiology Intensive Therapy
Julian L Wichmann, Richard W Katzberg, Sheldon E Litwin, Peter L Zwerner, Carlo N De Cecco, Thomas J Vogl, Philip Costello, U Joseph Schoepf
No abstract text is available yet for this article.
November 17, 2015: Circulation
William F Peacock, Chad M Cannon, Adam J Singer, Brian C Hiestand
The diagnosis of patients presenting to the emergency department with acute heart failure (AHF) is challenging due to the similarity of AHF symptoms to other conditions such as chronic obstructive pulmonary disease and pneumonia. Additionally, because AHF is most common in an older population, the presentation of coexistent pathologies further increases the challenge of making an accurate diagnosis and selecting the most appropriate treatment. Delays in the diagnosis and treatment of AHF can result in worse outcomes and higher healthcare costs...
November 10, 2015: Critical Care: the Official Journal of the Critical Care Forum
Eric J Velazquez, Zainab Samad, Hussein R Al-Khalidi, Chithra Sangli, Paul A Grayburn, Joseph M Massaro, Susanna R Stevens, Ted E Feldman, Mitchell W Krucoff
BACKGROUND: We compared 30-day and 1-year survival among high-risk mitral regurgitation (MR) patients treated with the MitraClip (Abbott Vascular, Abbott Park, IL) with matched non-surgically treated patients from the Duke Echocardiography Laboratory Database (DELD). METHODS AND RESULTS: High-risk patients with 3+/4+ MR managed non-surgically between years 2000 and 2010 in the longitudinal DELD were matched to high-risk MitraClip patients. Patient matching was performed using the method of nearest available Mahalanobis distance metric within calipers defined by the propensity score...
November 2015: American Heart Journal
Klaus Peter Rentrop, Frederick Feit
More than 20 years of misconceptions derailed acceptance of reperfusion therapy for acute myocardial infarction (AMI). Cardiologists abandoned reperfusion for AMI using fibrinolytic therapy, explored in 1958, because they no longer attributed myocardial infarction to coronary thrombosis. Emergent aortocoronary bypass surgery, pioneered in 1968, remained controversial because of the misconception that hemorrhage into reperfused myocardium would result in infarct extension. Attempts to limit infarct size by pharmacotherapy without reperfusion dominated research in the 1970s...
November 2015: American Heart Journal
Massimo Imazio, Fiorenzo Gaita, Martin LeWinter
IMPORTANCE: Pericarditis is the most common form of pericardial disease and a relatively common cause of chest pain. OBJECTIVE: To summarize published evidence on the causes, diagnosis, therapy, prevention, and prognosis of pericarditis. EVIDENCE REVIEW: A literature search of BioMedCentral, Google Scholar, MEDLINE, Scopus, and the Cochrane Database of Systematic Reviews was performed for human studies without language restriction from January 1, 1990, to August 31, 2015...
October 13, 2015: JAMA: the Journal of the American Medical Association
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