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RPHICUTeaching2016.1-Cardiogenic Shock

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7 papers 0 to 25 followers Research Papers used in aid of the in-house ICU registrar teaching programme at Royal Perth Hospital in the first half of 2016.
Sanjiv J Shah
Pulmonary hypertension (PH), defined as elevated pulmonary artery pressure, is common in the general population and associated with increased mortality. Accordingly, physicians commonly encounter patients with dyspnea, exercise intolerance, and/or right heart failure who have elevated pulmonary artery systolic pressure (PASP) on echocardiography. Although pulmonary arterial vasodilators may often be considered in this setting, these drugs have been predominantly tested in the subset of PH patients with pulmonary arterial hypertension (PAH)...
October 3, 2012: JAMA: the Journal of the American Medical Association
Holger Thiele, Uwe Zeymer, Franz-Josef Neumann, Miroslaw Ferenc, Hans-Georg Olbrich, Jörg Hausleiter, Gert Richardt, Marcus Hennersdorf, Klaus Empen, Georg Fuernau, Steffen Desch, Ingo Eitel, Rainer Hambrecht, Jörg Fuhrmann, Michael Böhm, Henning Ebelt, Steffen Schneider, Gerhard Schuler, Karl Werdan
BACKGROUND: In current international guidelines, intraaortic balloon counterpulsation is considered to be a class I treatment for cardiogenic shock complicating acute myocardial infarction. However, evidence is based mainly on registry data, and there is a paucity of randomized clinical trials. METHODS: In this randomized, prospective, open-label, multicenter trial, we randomly assigned 600 patients with cardiogenic shock complicating acute myocardial infarction to intraaortic balloon counterpulsation (IABP group, 301 patients) or no intraaortic balloon counterpulsation (control group, 299 patients)...
October 4, 2012: New England Journal of Medicine
Gabriel T Sayer, Joshua N Baker, Kimberly A Parks
PURPOSE OF REVIEW: Cardiogenic shock is present in 3.5% of patients presenting with acute decompensated heart failure. Despite advances in therapy, mortality remains high, approaching 70% in some settings. Recent management strategies have incorporated the use of mechanical circulatory support (MCS), which has been associated with better survival in nonrandomized trials. MCS is increasingly used in the acute setting and has become an important treatment modality for cardiogenic shock...
October 2012: Current Opinion in Critical Care
Etienne Gayat, Alexandre Mebazaa
PURPOSE OF REVIEW: To review the contemporary management of patients with pulmonary hypertension in critical care. RECENT FINDINGS: The normal mean pulmonary artery pressure (mPAP) at rest is 14±3  mmHg and pulmonary hypertension is considered when mPAP is greater than or equal to 25  mmHg at rest. The classification of pulmonary hypertension has been redefined recently and updated in 2009 and could help to guide the management of patients with pulmonary hypertension in critical care...
October 2011: Current Opinion in Critical Care
Steve Allen, Daniel Holena, Maureen McCunn, Benjamin Kohl, Babak Sarani
Extracorporeal membrane oxygenation (ECMO) comprises a commonly used method of extracorporeal life support. It has proven efficacy and is an accepted modality of care for isolated respiratory or cardiopulmonary failure in neonatal and pediatric populations. In adults, there are conflicting studies regarding its benefit, but it is possible that ECMO may be beneficial in certain adult populations beyond postcardiotomy heart failure. As such, all intensivists should be familiar with the evidence-base and principles of ECMO in adult population...
January 2011: Journal of Intensive Care Medicine
Laura C Price, Stephen J Wort, Simon J Finney, Philip S Marino, Stephen J Brett
INTRODUCTION: Pulmonary vascular dysfunction, pulmonary hypertension (PH), and resulting right ventricular (RV) failure occur in many critical illnesses and may be associated with a worse prognosis. PH and RV failure may be difficult to manage: principles include maintenance of appropriate RV preload, augmentation of RV function, and reduction of RV afterload by lowering pulmonary vascular resistance (PVR). We therefore provide a detailed update on the management of PH and RV failure in adult critical care...
2010: Critical Care: the Official Journal of the Critical Care Forum
Harmony R Reynolds, Judith S Hochman
No abstract text is available yet for this article.
February 5, 2008: Circulation
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