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UNIDAD CORONARIA

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144 papers 25 to 100 followers
By Elvis Amao Internal Medicine , Cardiology and infectious diseases
https://www.readbyqxmd.com/read/28763361/dexmedetomidine-associated-hyperthermia-a-series-of-9-cases-and-a-review-of-the-literature
#1
Bernard D Krüger, Judith Kurmann, Natascia Corti, Donat R Spahn, Dominique Bettex, Alain Rudiger
Dexmedetomidine, an α2-adrenergic agonist, can be used to perform mild to moderate sedation in critically ill patients. In this case series, 9 cardiovascular intensive care unit patients with hyperthermia during dexmedetomidine administration, suggestive of drug fever, are presented. Hyperthermia (>38.5°C) occurred 6 (4-10) hours (median [interquartile range]) after dexmedetomidine initiation at a dose of 1.0 (0.8-1.3) μg/kg/h and was resolved 3 (1-8) hours after discontinuation of dexmedetomidine. All patients were screened for infectious and noninfectious causes of hyperthermia, and the findings were analyzed by 2 adverse drug reaction (ADR) assessment methods-the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) Causality Assessment and the Naranjo ADR scale...
July 28, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28736324/survival-and-neurological-outcome-in-the-elderly-after-in-hospital-cardiac-arrest
#2
G Hirlekar, T Karlsson, S Aune, A Ravn-Fischer, P Albertsson, J Herlitz, B Libungan
BACKGROUND: There have been few studies of the outcome in elderly patients who have suffered in-hospital cardiac arrest (IHCA) and the association between cardiac arrest characteristics and survival. AIM: The aim of this large observational study was to investigate the survival and neurological outcome in the elderly after IHCA, and to identify which factors were associated with survival. METHODS: We investigated elderly IHCA patients (≥70years of age) who were registered in the Swedish Cardiopulmonary Resuscitation Registry 2007-2015...
September 2017: Resuscitation
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#3
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28575211/clinical-outcomes-in-patients-after-extracorporeal-membrane-oxygenation-support-for-post-cardiotomy-cardiogenic-shock-a-single-centre-experience-of-92-cases%C3%A2
#4
Julien Guihaire, Simon Dang Van, Simon Rouze, Sébastien Rosier, Antoine Roisne, Thierry Langanay, Hervé Corbineau, Jean-Philippe Verhoye, Erwan Flécher
OBJECTIVES: Post-cardiotomy cardiogenic shock is a major concern in cardiac surgery. We reviewed our experience of extracorporeal membrane oxygenation (ECMO) as temporary circulatory support in post-cardiotomy cardiogenic shock. METHODS: Between January 2005 and December 2014, adult patients implanted with ECMO after cardiac surgical procedures were included. Indications for ECMO were failure to be withdrawn from cardiopulmonary bypass or refractory cardiogenic shock occurring during postoperative Days 1 and 2...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28506136/predictors-to-intravenous-fluid-responsiveness
#5
Jorge Iván Alvarado Sánchez, William Fernando Amaya Zúñiga, Manuel Ignacio Monge García
Management with intravenous fluids can improve cardiac output in some surgical patients. Management with static preload indicators, such as central venous pressure and pulmonary artery occlusion pressure, has not demonstrated a suitable relationship with changes in the cardiac output induced by intravenous fluid therapy. Dynamic indicators, such as the variability of arterial pulse pressure or stroke volume variation, have demonstrated a suitable relationship. Since improvement in cardiac output does not guarantee an adequate perfusion pressure, in patients with hypotension, it is also necessary to know whether arterial pressure will also increase with intravenous fluid therapy...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28234783/is-there-still-a-role-for-hypothermia-in-neurocritical-care
#6
Florian Frank, Gregor Broessner
PURPOSE OF REVIEW: Therapeutic hypothermia (i.e. induced body core temperature ≈ 33-35°C) in neurological patients with cerebrovascular disease and traumatic brain injury is a controversially discussed issue in the literature. In this review, we have included the most recently published research covering the use of therapeutic hypothermia and targeted temperature management in neurologic diseases and translated the results into a clinical decision support for the professional healthcare community...
April 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28383297/supportive-technology-in-the-resuscitation-of-out-of-hospital-cardiac-arrest-patients
#7
Scott T Youngquist, Kenneth A Scheppke, Paul E Pepe
PURPOSE OF REVIEW: To discuss the increasing value of technological tools to assess and augment the quality of cardiopulmonary resuscitation (CPR) and, in turn, improve chances of surviving out-of-hospital cardiac arrest (OHCA). RECENT FINDINGS: After decades of disappointing survival rates, various emergency medical services systems worldwide are now seeing a steady rise in OHCA survival rates guided by newly identified 'sweet spots' for chest compression rate and chest compression depth, aided by monitoring for unnecessary pauses in chest compressions as well as methods to better ensure full-chest recoil after compressions...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28398907/cardiopulmonary-monitoring-of-shock
#8
James Simmons, Corey E Ventetuolo
PURPOSE OF REVIEW: We will briefly review the classification of shock and the hallmark features of each subtype. Available modalities for monitoring shock patients will be discussed, along with evidence supporting the use, common pitfalls, and practical considerations of each method. RECENT FINDINGS: As older, invasive monitoring methods such as the pulmonary artery catheter have fallen out of favor, newer technologies for cardiac output estimation, echocardiography, and noninvasive tests such as passive leg raising have gained popularity...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28402985/the-past-present-and-future-of-ventilation-during-cardiopulmonary-resuscitation
#9
Mary P Chang, Ahamed H Idris
PURPOSE OF REVIEW: To evaluate the past and present literature on ventilation during out of hospital cardiac arrest, highlighting research that has informed current guidelines. RECENT FINDINGS: Previous studies have studied what are optimal compression-to-ventilation ratios, ventilation rates, and methods of ventilation. Continuous chest compression cardiopulmonary resuscitation (CPR) has not shown to provide a significant survival benefit over the traditional 30 : 2 CPR...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28499130/extracorporeal-membrane-oxygenation-ecmo-as-a-treatment-strategy-for-severe-acute-respiratory-distress-syndrome-ards-in-the-low-tidal-volume-era-a-systematic-review
#10
REVIEW
Bourke W Tillmann, Michelle L Klingel, Alla E Iansavichene, Ian M Ball, A Dave Nagpal
OBJECTIVE: To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone. METHODS: Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of ECMO with low tidal volume ventilation to mechanical ventilation with a low tidal volume alone. Only studies reporting hospital or ICU survival were included...
April 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28470918/isolated-left-ventricular-failure-is-a-predictor-of-poor-outcome-in-patients-receiving-veno-arterial-extracorporeal-membrane-oxygenation
#11
Corstiaan A den Uil, Lucia S Jewbali, Martijn J Heeren, Alina A Constantinescu, Nicolas M Van Mieghem, Dinis Dos Reis Miranda
AIMS: We investigated survival according to the nature of heart failure (isolated left, vs isolated right, vs biventricular heart failure) in patients undergoing extracorporeal membrane oxygenation (ECMO) for refractory cardiogenic shock of different causes. METHODS AND RESULTS: This single-center study included 132 patients with acute myocardial infarction (20%), acute on chronic heart failure (14%), post cardiotomy (17%), cardiac allograft failure (8%), pulmonary embolism (16%), and acute nonischemic heart failure (25%)...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28500585/systematic-review-and-meta-analysis-of-complications-and-mortality-of-veno-venous-extracorporeal-membrane-oxygenation-for-refractory-acute-respiratory-distress-syndrome
#12
REVIEW
Sergi Vaquer, Candelaria de Haro, Paula Peruga, Joan Carles Oliva, Antonio Artigas
Veno-venous extracorporeal membrane oxygenation (ECMO) for refractory acute respiratory distress syndrome (ARDS) is a rapidly expanding technique. We performed a systematic review and meta-analysis of the most recent literature to analyse complications and hospital mortality associated with this technique. Using the PRISMA guidelines for systematic reviews and meta-analysis, MEDLINE and EMBASE were systematically searched for studies reporting complications and hospital mortality of adult patients receiving veno-venous ECMO for severe and refractory ARDS...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28418691/editor-s-choice-the-organization-of-chest-pain-units-position-statement-of-the-acute-cardiovascular-care-association
#13
Marc J Claeys, Ingo Ahrens, Peter Sinnaeve, Roberto Diletti, Roberta Rossini, Patrick Goldstein, Kasia Czerwińska, Héctor Bueno, Maddalena Lettino, Thomas Münzel, Uwe Zeymer
Chest pain units are defined as organizational short stay units with specific management protocols designed to facilitate and optimize the diagnosis of patients presenting with chest pain in the emergency department. The present document is intended to standardize and facilitate the installation of chest pain units nearby to the emergency department or as an integral part of the emergency department. Recommendations on organizational structure, physical and technical requirements and on disease management are presented...
April 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28452562/risk-factors-of-late-cardiogenic-shock-and-mortality-in-st-segment-elevation-myocardial-infarction-patients
#14
Laust Obling, Martin Frydland, Rikke Hansen, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lene Holmvang, Hanne Berg Ravn, Sebastian Wiberg, Jakob Hartvig Thomsen, Lisette Okkels Jensen, Jesper Kjærgaard, Jacob Eifer Møller, Christian Hassager
BACKGROUND: The incidence of cardiogenic shock (CS) in patients with ST-segment elevation myocardial infarction (STEMI) is as high as 10%. The majority of patients are thought to develop CS after admission (late CS), but the incidence in a contemporary STEMI cohort admitted for primary percutaneous intervention remains unknown. AIM: The aim of this study was to assess the incidence and time of CS onset in patients with suspected STEMI admitted in two high-volume tertiary heart centres and to assess the variables associated with the development of late CS...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28485200/assessment-of-early-treatment-response-by-rapid-cardiothoracic-ultrasound-in-acute-heart-failure-cardiac-filling-pressures-pulmonary-congestion-and-mortality
#15
Jonas Öhman, Veli-Pekka Harjola, Pasi Karjalainen, Johan Lassus
BACKGROUND: It is unclear how to optimally monitor acute heart failure (AHF) patients. We evaluated the timely interplay of cardiac filling pressures, brain natriuretic peptides (BNPs), lung ultrasound (LUS) and symptoms during AHF treatment. METHODS: We enrolled 60 patients who had been hospitalised for AHF. Patients were examined with a rapid cardiothoracic ultrasound (CaTUS) protocol, combining LUS and focused echocardiographic evaluation of cardiac filling pressures (i...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28479041/cardiogenic-shock-management-still-a-challenge-and-a-need-for-large-registry-data
#16
Clement Delmas, Guillaume Leurent, Nicolas Lamblin, Eric Bonnefoy, François Roubille
No abstract text is available yet for this article.
August 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28466461/high-flow-nasal-cannula-to-prevent-postextubation-respiratory-failure-in-high-risk-non-hypercapnic-patients-a-randomized-multicenter-trial
#17
Rafael Fernandez, Carles Subira, Fernando Frutos-Vivar, Gemma Rialp, Cesar Laborda, Joan Ramon Masclans, Amanda Lesmes, Luna Panadero, Gonzalo Hernandez
BACKGROUND: Extubation failure is associated with increased morbidity and mortality, but cannot be safely predicted or avoided. High-flow nasal cannula (HFNC) prevents postextubation respiratory failure in low-risk patients. OBJECTIVE: To demonstrate that HFNC reduces postextubation respiratory failure in high-risk non-hypercapnic patients compared with conventional oxygen. METHODS: Randomized, controlled multicenter trial in patients who passed a spontaneous breathing trial...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28474317/acute-kidney-injury-in-the-icu-from-injury-to-recovery-reports-from-the-5th-paris-international-conference
#18
REVIEW
Rinaldo Bellomo, Claudio Ronco, Ravindra L Mehta, Pierre Asfar, Julie Boisramé-Helms, Michael Darmon, Jean-Luc Diehl, Jacques Duranteau, Eric A J Hoste, Joannes-Boyau Olivier, Matthieu Legrand, Nicolas Lerolle, Manu L N G Malbrain, Johan Mårtensson, Heleen M Oudemans-van Straaten, Jean-Jacques Parienti, Didier Payen, Sophie Perinel, Esther Peters, Peter Pickkers, Eric Rondeau, Miet Schetz, Christophe Vinsonneau, Julia Wendon, Ling Zhang, Pierre-François Laterre
The French Intensive Care Society organized its yearly Paris International Conference in intensive care on June 18-19, 2015. The main purpose of this meeting is to gather the best experts in the field in order to provide the highest quality update on a chosen topic. In 2015, the selected theme was: "Acute Renal Failure in the ICU: from injury to recovery." The conference program covered multiple aspects of renal failure, including epidemiology, diagnosis, treatment and kidney support system, prognosis and recovery together with acute renal failure in specific settings...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28320439/mechanical-ventilation-in-obese-icu-patients-from-intubation-to-extubation
#19
REVIEW
Audrey De Jong, Gerald Chanques, Samir Jaber
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/28499516/improving-cpr-performance
#20
REVIEW
Boulos S Nassar, Richard Kerber
Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. Cardiopulmonary resuscitation (CPR) is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Key steps health care systems can take to enhance the quality of CPR and, potentially, to improve outcomes, include optimizing chest compressions; avoiding hyperventilation; encouraging intraosseus access, and monitoring capnography...
May 9, 2017: Chest
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