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UNIDAD CORONARIA

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118 papers 25 to 100 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/28328299/early-left-ventricular-ejection-fraction-as-a-predictor-of-survival-after-cardiac-arrest
#1
Barry Burstein, Dev Jayaraman, Regina Husa
Although echocardiograms are frequently performed within 24 h of sudden cardiac death, the utility of left ventricular ejection fraction (LVEF) to predict survival is unknown. In this single center retrospective cohort study of patients admitted to the intensive care unit or coronary care unit after in-hospital or out-of-hospital sudden cardiac death, LVEF <40% was not a significant predictor of survival at 30 days or hospital discharge. ABSTRACT Background: Cardiopulmonary resuscitation and early defibrillation have been shown to improve outcomes of cardiac arrest...
March 22, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/28342510/arterial-protocol-including-prophylactic-distal-perfusion-catheter-decreases-limb-ischemia-complications-in-patients-undergoing-extracorporeal-membrane-oxygenation
#2
Kathleen M Lamb, Paul J DiMuzio, Adam Johnson, Philip Batista, Neil Moudgill, Megan McCullough, Joshua A Eisenberg, Hitoshi Hirose, Nicholas C Cavarocchi
OBJECTIVE: Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complications (10%-70%). This study evaluates the results of a distal limb perfusion arterial protocol designed to reduce associated complications. METHODS: We conducted a retrospective institutional review board-approved review of consecutive patients requiring ECMO via femoral cannulation (July 2010-January 2015)...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28343949/lactate-and-echocardiography-before-veno-venous-extracorporeal-membrane-oxygenation-support
#3
Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Stefano Batacchi, Paolo Terenzi, Morena Cozzolino, Pasquale Bernardo, Adriano Peris
BACKGROUND: Lactate has been recognised as a prognostic factor in several critical conditions. Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) is a well-established therapy in patients with Acute Respiratory Disease Syndrome (ARDS) unresponsive to conventional therapy and echocardiography pre ECMO initiation has been recently reported to help in risk stratifying these patients. METHODS: We assessed whether the detection of hyperlactataemia could be associated with the presence of left ventricle (LV) or right ventricle (RV) dysfunction in 121 consecutive patients with refractory ARDS...
March 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28375997/patients-and-families-satisfaction-with-visiting-policies-in-cardiac-intensive-care-units
#4
Shiva Khaleghparast, Soodabeh Joolaee, Majid Maleki, Hamid Peyrovi, Behrooz Ghanbari, Naser Bahrani
BACKGROUND: Families play a vital role in the recovery of patients admitted to intensive care units. They can help patients to adapt themselves to the crisis and feel more satisfied. OBJECTIVE: In this study, we examined the patients' and families' satisfaction with the current visiting policies in cardiac intensive care units in the largest Cardiovascular Medical and Research Center of Iran. METHOD: This research used a cross-sectional descriptive design...
May 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28366285/a-review-of-hemodynamic-monitoring-techniques-methods-and-devices-for-the-emergency-physician
#5
Abdullah E Laher, Matthew J Watermeyer, Sean K Buchanan, Nicole Dippenaar, Nelly Clotilde Tchouambou Simo, Feroza Motara, Muhammed Moolla
The emergency department (ED) is frequently the doorway to the intensive care unit (ICU) for a significant number of critically ill patients presenting to the hospital. Hemodynamic monitoring (HDM) which is a key component in the effective management of the critically ill patient presenting to the ED, is primarily concerned with assessing the performance of the cardiovascular system and determining the correct therapeutic intervention to optimise end-organ oxygen delivery. The spectrum of hemodynamic monitoring ranges from simple clinical assessment and routine bedside monitoring to point of care ultrasonography and various invasive monitoring devices...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336761/impact-of-an-antimicrobial-stewardship-initiative-on-time-to-administration-of-empirical-antibiotic-therapy-in-hospitalized-patients-with-bacteremia
#6
Tiffany E Bias, William R Vincent, Nathan Trustman, Leonard B Berkowitz, Veena Venugopalan
PURPOSE: The impact of an antimicrobial stewardship initiative on time to first antibiotic dose and clinical outcomes in bacteremic patients was evaluated. METHODS: A single-center, retrospective study was conducted for adult inpatients who received antibiotics before and after implementation of a rapid administration of antimicrobials by an infectious diseases specialist (RAIDS) protocol. Patients admitted to an inpatient service from June to October 2011 (pre-RAIDS protocol) and from December 2011 to February 2012 (post-RAIDS protocol) were eligible for inclusion if (1) they were age 18 years or older, (2) their infection occurred two or more days after hospital admission, and (3) they had a blood culture growing an organism other than common skin contaminants (i...
April 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28320242/early-goal-directed-therapy-for-septic-shock-a-patient-level-meta-analysis
#7
(no author information available yet)
Background After a single-center trial and observational studies suggesting that early, goal-directed therapy (EGDT) reduced mortality from septic shock, three multicenter trials (ProCESS, ARISE, and ProMISe) showed no benefit. This meta-analysis of individual patient data from the three recent trials was designed prospectively to improve statistical power and explore heterogeneity of treatment effect of EGDT. Methods We harmonized entry criteria, intervention protocols, outcomes, resource-use measures, and data collection across the trials and specified all analyses before unblinding...
March 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28320437/anemia-and-blood-transfusion-in-the-critically-ill-patient-with-cardiovascular-disease
#8
REVIEW
Annemarie B Docherty, Timothy S Walsh
This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2017. Other selected articles can be found online at http://ccforum.com/series/annualupdate2017 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901 .
March 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28284292/the-abcdef-bundle-in-critical-care
#9
REVIEW
Annachiara Marra, E Wesley Ely, Pratik P Pandharipande, Mayur B Patel
The ABCDEF bundle represents an evidence-based guide for clinicians to approach the organizational changes needed for optimizing intensive care unit patient recovery and outcomes. This article reviews the core evidence and features behind the ABCDEF bundle. The bundle has individual components that are clearly defined, flexible to implement, and help empower multidisciplinary clinicians and families in the shared care of the critically ill. The ABCDEF bundle helps guide well-rounded patient care and optimal resource utilization resulting in more interactive intensive care unit patients with better controlled pain, who can safely participate in higher-order physical and cognitive activities at the earliest point in their critical illness...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28284295/ventilator-associated-pneumonia-new-definitions
#10
REVIEW
M Chance Spalding, Michael W Cripps, Christian T Minshall
The National Healthcare Safety Network's new classification characterizes all adverse ventilator-associated events (VAE) into a tiered system designed to shift the focus away from ventilator-associated pneumonia as the only important cause or morbidity in ventilated patients. This new surveillance definition of VAE eliminates subjectivity by using clearly defined criteria and facilitates the automated collection of data. This allows for easier comparison and analysis of factors affecting rates of VAE. Numerous studies have been published that demonstrate its clinical application...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28284296/oxygen-therapeutics-and-mechanical-ventilation-advances
#11
REVIEW
Brian Weiss, Lewis J Kaplan
Advances in intensive care unit (ICU) therapeutics are plentiful and rooted in technological enhancements as well as recognition of patient care priorities. A plethora of new devices and modes are available for use to enhance patient safety and support liberation from mechanical ventilation while preserving oxygenation and carbon dioxide clearance. Increased penetrance of closed loop systems is one means to reduce care variation in appropriate populations. The intelligent design of the ICU space needs to integrate the footprint of that device and the data streaming from it into a coherent whole that supports patient, family, and caregivers...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28284297/tracheostomy-update-when-and-how
#12
REVIEW
Bradley D Freeman
Tracheostomy remains one of the most commonly performed surgical procedures in the setting of acute respiratory failure. Tracheostomy literature focuses on 2 aspects of this procedure: when (timing) and how (technique). Recent trials have failed to demonstrate an effect of tracheostomy timing on most clinically important endpoints. Nonetheless, relative to continued translaryngeal intubation, studies suggest that tracheostomy use is associated with less need for sedation and enhanced patient comfort. Evidence likewise suggests that percutaneous dilational tracheostomy is advantageous with respect to cost and complication profile and should be considered the preferred approach in appropriately selected patients...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28284299/anemia-and-red-blood-cell-transfusion-advances-in-critical-care
#13
REVIEW
Lena M Napolitano
Anemia is common in the intensive care unit (ICU), resulting in frequent administration of red blood cell (RBC) transfusions. Significant advances have been made in understanding the pathophysiology of anemia in the ICU, which is anemia of inflammation. This anemia is related to high hepcidin concentrations resulting in iron-restricted erythropoiesis, and decreased erythropoietin concentrations. A new hormone (erythroferrone) has been identified, which mediates hepcidin suppression to allow increased iron absorption and mobilization from iron stores...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28265980/outcomes-in-elderly-patients-admitted-to-the-intensive-care-unit-with-solid-tumors
#14
Edouard Auclin, Anaïs Charles-Nelson, Baptiste Abbar, Emmanuel Guérot, Stéphane Oudard, Caroline Hauw-Berlemont, Constance Thibault, Alexandra Monnier, Jean-Luc Diehl, Sandrine Katsahian, Jean-Yves Fagon, Julien Taieb, Nadia Aissaoui
BACKGROUND: As the population ages and cancer therapies improve, there is an increased call for elderly cancer patients to be admitted to the intensive care unit (ICU). This study aimed to assess short-term survival and prognostic factors in critically ill patients with solid tumors aged ≥65 years. METHODS: We conducted a retrospective study. The primary endpoint was ICU mortality. Resumption of anticancer therapy in patients who survived the ICU stay and 90-day mortality were secondary endpoints...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28275619/extracorporeal-membrane-oxygenation-in-the-pre-and-post-lung-transplant-period
#15
REVIEW
Nirmal S Sharma, Mathew G Hartwig, Don Hayes
Evolution in technology has resulted in rapid increase in utilization of extracorporeal membrane oxygenation (ECMO) as a bridge to recovery and/or transplantation. Although there is limited evidence for the use of ECMO, recent improvements in ECMO technology, personnel training, ambulatory practices on ECMO and lung protective strategies have resulted in improved outcomes in patients bridged to lung transplantation. This review provides an insight into the current outcomes and best practices for utilization of ECMO in the pre- and post-lung transplantation period...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28286833/ventilator-associated-pneumonia-and-its-responsible-germs-an-epidemiological-study
#16
Rama Bozorgmehr, Vanousheh Bahrani, Alireza Fatemi
INTRODUCTION: Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in prevalence of hospital infections, the present study was designed aiming to determine the prevalence of VAP and its bacterial causes. METHODS: In this cross-sectional study, the medical profiles of all the patients under mechanical ventilation, who had no symptoms of pneumonia at the time of intubation and developed new infiltration in chest radiography after 48 hours under mechanical ventilation along with at least 2 of the symptoms including fever, hypothermia, leukocytosis, leukopenia, or purulent discharge from the lungs, were evaluated...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28260911/increased-risk-of-endotracheal-intubation-and-heart-failure-following-acute-myocardial-infarction-in-patients-with-urolithiasis-a-nationwide-population-based-study
#17
Shun-Ku Lin, Jui-Ming Liu, Ying-Hsu Chang, Yuan-Tien Ting, See-Tong Pang, Ren-Jun Hsu, Po-Hung Lin
BACKGROUND: Urolithiasis is a common urinary tract disease worldwide. It has been connected to systemic diseases, including hypertension, diabetes mellitus, metabolic syndrome, and cardiovascular disease. In the current study, we aimed to evaluate the relationship between urolithiasis and the complications of acute myocardial infarction (AMI). MATERIALS AND METHODS: Data were obtained from the Longitudinal Health Insurance Database 2005 of the National Health Insurance Research Database...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28237895/anticoagulation-practices-and-the-prevalence-of-major-bleeding-thromboembolic-events-and-mortality-in-venoarterial-extracorporeal-membrane-oxygenation-a-systematic-review-and-meta-analysis
#18
Eric Sy, Michael C Sklar, Laurence Lequier, Eddy Fan, Hussein D Kanji
PURPOSE: The purpose was to evaluate the safety of anticoagulation in venoarterial extracorporeal membrane oxygenation (VA-ECMO). DESIGN: We performed a systematic review and meta-analysis using multiple electronic databases. Studies were from 1977 to September 27, 2016. We evaluated the effect of anticoagulation in VA-ECMO on outcomes including major bleeding, thromboembolic events, and in-hospital mortality using a random effects model meta-analysis. RESULTS: Twenty-six studies (1496 patients) were included...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28236098/use-of-extracorporeal-membrane-oxygenation-in-complicated-transcatheter-aortic-valve-replacement
#19
Kyokun Uehara, Kenji Minakata, Naritatsu Saito, Masao Imai, Hiroki Daijo, Taro Nakatsu, Kazuhisa Sakamoto, Kazuhiro Yamazaki, Takeshi Kimura, Ryuzo Sakata
OBJECTIVES: Although transcatheter aortic valve replacement (TAVR) is an excellent alternative procedure for high-risk patients with severe symptomatic aortic stenosis, it is often associated with life-threatening complications. We report on the emergency or elective use of veno-arterial extracorporeal membrane oxygenation (ECMO) to manage these complications. METHODS: Between December 2013 and February 2016, 46 patients underwent TAVR at our institution. Of these, 4 patients required emergency ECMO support and another 3 patients were electively placed on ECMO support at the start of the procedure...
February 24, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28224105/nutrient-stimulation-of-mesenteric-blood-flow-implications-for-older-critically-ill-patients
#20
REVIEW
Thu An Nguyen, Yasmine Ali Abdelhamid, Liza K Phillips, Leeanne S Chapple, Michael Horowitz, Karen L Jones, Adam M Deane
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death...
February 4, 2017: World Journal of Critical Care Medicine
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