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1.
Gbolahan O. Ogunbayo Le Dung Ha Qamar Ahmad Naoki Misumida Ayman Elbadawi Odunayo Olorunfemi Andrew Kolodziej Adrian W. Messerli Ahmed Abdel-Latif Claude S. Elayi Maya Guglin 《Heart & lung : the journal of critical care》2018,47(4):392-397
Introduction
This study compared inpatient outcomes related to the use of these two devices among patients who developed cardiogenic shock not due to acute myocardial infarction or coronary revascularization.Methods
We extracted admission-level records of patients with a diagnosis of cardiogenic shock who underwent either PVAD or IABP implantation from the National Inpatient Sample (NIS) database from 2010 to 2014. Our outcomes of interest were mortality and length of stay.Results
Inpatient mortality was significantly higher in the PVAD cohort. In multivariate analysis, PVAD use in these patients was associated with higher mortality. There was no difference in the length of stay between both groups among patients that survived to discharge.Conclusion
In our analysis of the NIS database, the use of PVADs in patients with cardiogenic shock of non-ischemic origin was associated with higher mortality when compared to IABP use. 相似文献2.
Eamon P. Raith Joshua F. Ihle Jennifer Jamieson Anna Kalff Julian Bosco 《Heart & lung : the journal of critical care》2018,47(4):425-428
Background
Idiopathic capillary leak syndrome (Clarkson's Disease) is a rare angiopathy with a heterogenous phenotype that may present as distributive shock refractory to resuscitative management.Objective
We report a case of idiopathic systemic capillary leak syndrome presenting as septic shock.Methods
Structured case report and review of the literature.Results
A 27-year old man admitted to our institution with coryzal symptoms rapidly deteriorated with presumed sepsis, leading to intensive care unit admission. Following further deterioration, Idiopathic systemic capillary leak syndrome was considered and intravenous immunoglobulin administered, resulting in rapid improvement in the patient's clinical status.Conclusions
Idiopathic systemic capillary leak syndrome is a rare and potentially life-threatening angiopathy that may present as, and should be considered in, refractory distributive shock. Administration of intravenous immunglobulin resulted in rapid recovery in this patient, and has been associated with positive outcomes in previous cases. 相似文献3.
Justin B. Echouffo-Tcheugui Dhaval Kolte Sahil Khera Herbert D. Aronow J. Dawn Abbott Deepak L. Bhatt Gregg C. Fonarow 《The American journal of medicine》2018,131(7):778-786.e1
Background
Diabetes mellitus (diabetes) increases the risk of acute myocardial infarction, which can result in cardiogenic shock. Data on the relation of diabetes and the occurrence and prognosis of cardiogenic shock postacute myocardial infarction are scant.Methods
Among the National Inpatient Sample patients aged ≥18 years and hospitalized for acute myocardial infarction during the 2012-2014 period, we examined the association between diabetes and the incidence and outcomes of cardiogenic shock complicating acute myocardial infarction, using multivariable logistic and linear regression models.Results
Of 1,332,530 hospitalizations for acute myocardial infarction, 72,765 (5.5%) were complicated by cardiogenic shock. In acute myocardial infarction patients, cardiogenic shock incidence was higher among those with vs without diabetes (5.8% vs 5.2%; adjusted odds ratio [aOR] 1.14; 95% confidence interval [CI], 1.11-1.19; P < .001), with 42.8% (n = 31,135) of patients with acute myocardial infarction and cardiogenic shock having diabetes. Diabetic patients were less likely to undergo revascularization (percutaneous coronary intervention or coronary artery bypass grafting) (67.1% vs 68.7%; aOR 0.88; 95% CI, 0.80-0.96; P = .003). Diabetes was associated with higher in-hospital mortality in patients with acute myocardial infarction and cardiogenic shock (37.9% vs 36.8%; aOR 1.18; 95% CI, 1.09-1.28; P < .001). Among survivors, patients with diabetes had a longer hospital stay (mean ± SEM: 11.6 ± 0.16 vs 10.9 ± 0.16 days; adjusted estimate 1.12; 95% CI, 1.06-1.18; P < .001) and were more likely to be discharged to a skilled nursing home or with home health care (56.0% vs 50.5%; aOR 1.19; 95% CI, 1.07-1.33; P = .001).Conclusions
In a large cohort of acute myocardial infarction patients, preexisting diabetes was associated with an increased risk of cardiogenic shock and worse outcomes in those with cardiogenic shock. 相似文献4.
Bülent Özlek Eda Özlek Oğuzhan Çelik Cem Çil Volkan Doğan Murat Biteker 《Heart & lung : the journal of critical care》2018,47(4):360-362
Background
Allergic myocardial infarction is a rare clinical entity.Objectives
Although a few number of case reports with severe anaphylactic reactions to recombinant human insulin have been reported, allergic myocardial infarction, known as Kounis Syndrome, has not been reported before.Methods
Herein, we report a 57-year-old woman with myocardial infarction, referred for urticarial rash, chest pain, and palpitations developed after the first subcutaneous dose of recombinant human insulin.Results
The patient treated with antihistamines and steroids and discharged from hospital in a good condition.Conclusions
Physicians should be aware of allergic myocardial infarction. The diagnosis of Kounis Syndrome should be entertained when allergic symptoms, electrocardiographic changes, and high cardiac enzymes accompany acute-onset chest pain. All patients admitted to the emergency department with chest pain and ST elevation on electrocardiography should be asked about allergic insults. 相似文献5.
Kyoungrim Kang Leila Gholizadeh Hae-Ra Han Sally C. Inglis 《Heart & lung : the journal of critical care》2018,47(2):142-148
Background
Experience of myocardial infarction (MI) negatively affects different aspects of health-related quality of life (HRQoL).Objectives
This study aimed to examine trends in HRQoL of MI patients and to identify demographic, clinical and psychosocial predictors of HRQoL at three months.Methods
A total of 150 patients in South Korea were completed the study questionnaires at baseline. After three months from discharge, 136 participants completed follow-up questionnaires, including the Korean version of the MacNew Quality of Life after Myocardial Infarction Questionnaire (MacNew).Results
HRQoL significantly improved over three months. Younger age, ST-elevation MI, and higher LVEF, lower level of depression, better understanding of the illness and higher perceived social support at baseline were associated with better HRQoL at three months.Conclusion
Providing adequate information about the illness and social support as well as reducing negative psychological experiences in early days after MI may improve HRQoL of MI patients. 相似文献6.
Jemima Boyd Jenny Paratz Oystein Tronstad Lawrence Caruana Paul McCormack James Walsh 《Heart & lung : the journal of critical care》2018,47(2):81-86
Rationale
Consensus recommendations have been developed to guide exercise rehabilitation of mechanically ventilated patients in the intensive care unit.Objective
This study aimed to investigate the safety of exercise rehabilitation of mechanically ventilated patients and evaluate the consensus recommendations.Methods
This was a prospective, single-centre, cohort study conducted in a specialist cardiothoracic intensive care unit of a tertiary, university affiliated hospital in Australia.Results
91 mechanically ventilated participants; 54 (59.3%) male; mean age of 56.52 (16.3) years; were studied with 809 occasions of service recorded. Ten (0.0182%) minor adverse events were recorded, with only one adverse event occurring when a patient was receiving moderate level of vasoactive support.Conclusions
The consensus recommendations are a useful tool in guiding safe exercise rehabilitation of mechanically ventilated patients. Our findings suggest that there is further scope to safely commence exercise rehabilitation in patients receiving vasoactive support. 相似文献7.
Iliana S. Hurtado Rendón Diego Alcivar Juan Pablo Rodriguez-Escudero Kevin Silver 《The American journal of medicine》2018,131(2):202-205
Background
Stress cardiomyopathy is a transient cardiac syndrome characterized by reversible left ventricular systolic dysfunction precipitated by emotional or physiologic stress. The presence of obstructive coronary artery disease has been noted in stress cardiomyopathy.Methods
We describe 3 case reports of patients with acute coronary syndrome and transient wall motion abnormalities not usually seen in the distribution of coronary artery disease.Results
In these 3 cases of acute myocardial infarction, the distribution of the culprit coronary occlusion was not concordant with the territory of transient wall motion abnormality. Follow-up demonstrated resolution of the wall motion abnormalities without intervention in these territories.Conclusion
We believe that the physiologic stress of the acute coronary syndrome may have precipitated the stress cardiomyopathy as presented by these patients. This is the first demonstration that stress cardiomyopathy may be precipitated by acute coronary syndrome. 相似文献8.
James M. Walter Chitaru Kurihara Thomas C. Corbridge Ankit Bharat 《Heart & lung : the journal of critical care》2018,47(4):398-400
Background
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications.Objectives
To provide an example of a common complication, circuit “chugging,” and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS.Methods
We use a clinical case to illustrate chugging and discuss potential management strategies.Results
Our patient received frequent boluses of albumin for intermittent circuit chugging contributing to a net positive fluid balance of roughly 6 liters 4 days after cannulation.Conclusions
Chugging is a common complication for patients on VV ECMO. A thoughtful approach to management may help limit potentially harmful fluid administration for patients with ARDS. 相似文献9.
Connie Schumacher Leslie Hussey Vincent Hall 《Heart & lung : the journal of critical care》2018,47(4):297-303
Objective
To explore the decision making processes undertaken by community-dwelling individuals with heart failure as they experience symptom changes.Background
Heart failure patients are responsible for daily self-management that includes responding to symptom fluctuations between exacerbations. Despite education, some patients fail to seek timely medical intervention when symptoms change.Methods
Semi-structured interviews were conducted with homecare patients after receiving self-management education. Grounded theory methods and qualitative software were used to collect and analyze the data.Results
Five themes were identified: perceiving symptoms, alleviating actions and control, normalizing symptoms, absence of help seeking behaviors, and decreased functional capacity. Normalizing symptoms included actions taken by participants to mitigate symptom fluctuations. Daily fluctuations were assimilated into normal life resulting in desensitization of symptom recognition and decreased functional capacity.Conclusions
Findings support the need to educate on early symptom recognition, the benefits of safe physical activity, and building a system to support self-management patient-physician collaboration. 相似文献10.
Mona A. Abed Nidal F. Eshah Debra K. Moser 《Heart & lung : the journal of critical care》2018,47(3):226-230
Background
In developing countries, the number of adults who develop myocardial infarction (MI) at a young age is high. The popularity of waterpipe smoking (WPS) has increased among the same age group. It is unknown if WPS contributes to the incidence of early-onset MI.Objective
To study the association of WPS with early-onset MI, which is defined as first MI occurring in individuals 18 ≥ age ≤ 45 years compared to those older than 45 years.Methods
This was a cross-sectional study. The association of WPS with first-time MI was compared between younger and older adults (N = 225).Results
Twenty-five percent of all participants developed an acute MI before the age of 46 years. Both cigarette and WPS were more common among younger first-time MI patients than older first-time MI patients.Conclusions
WPS is one risk factor that distinguishes the risk profile of young adults with early-onset MI. 相似文献11.
Benjamin Marchandot François Levy Nicola Santelmo Paul-Michel Mertes Olivier Morel 《Heart & lung : the journal of critical care》2018,47(3):248-249
Background
Adequate strategies using either transthoracic (TTE) or transesophageal (TEE) echocardiography in patients receiving cardiopulmonary resuscitation (CPR) is an ongoing area of research.Objectives
As transthoracic point-of-care ultrasound (POCUS) during cardiac arrest resuscitation might result in an increased duration of interruptions in the delivery of chest compressions; the use of TEE has been proposed as an alternative.Methods
No technical complications of either TTE nor TEE are so far being reported in the literature.Results
We report the case of a left intramural atrial hematoma complicating TEE procedure during cardiac arrest. This highlights a unique and to our knowledge, first-in-man, described complicating TEE procedure during CPR.Conclusions
Further research on the safety of transesophageal echo during CRP is mandatory and the question about any potential harm of particular interest. 相似文献12.
Sim Leng Ooi Betsy Seah Vivien Xi Wu Karen Wei Ling Koh Nana Jiao Hong-Gu He Wenru Wang 《Heart & lung : the journal of critical care》2018,47(4):329-336
Background
Despite the increasing use of implantable cardioverter defibrillators (ICDs) as a preventive approach for high-risk patients with arrhythmias, little is known about the perceptions of ICD recipients regarding these devices and their impact on quality of life.Objectives
To explore perceptions towards quality of life, coping strategies, and learning needs of patients living with ICDs in Singapore.Methods
16 participants (age ranges 52 to 84 years old) were purposively recruited and interviewed individually for this exploratory qualitative study. Data collected was analyzed using thematic analysis.Results
Seven themes emerged: experiencing ICD shocks, ambivalent “love-hate” relationship with ICD, receiving support from healthcare professionals and social networks, attaining acceptance and returning to normalcy, physical coping, emotional coping, and readiness and need for enhanced patient education.Conclusions
With an insight to the perceptions of ICD recipients in Singapore, future practice can focus on addressing their concerns and improve post-implantation quality of life. 相似文献13.
Chunhua Ma Wei Zhou Qiubo Tang Shuling Huang 《Heart & lung : the journal of critical care》2018,47(4):337-344
Objectives
To test the effects of group-based Tai chi on health-status outcomes among older adults with hypertension.Background
A high-quality study exploring the effects of Tai chi on physical and psychosocial health for older adults with hypertension is needed in China. The long-term effects of group-based Tai chi in Chinese older adults with hypertension remain unclear.Methods
A randomized controlled trial was conducted. The group-based Tai chi training and practice were implemented in older adults over six-month.Results
The Tai chi (TC) group showed significantly lower blood pressure and body mass index than the usual care (UC) group. The TC group participants showed greater improvements in social support, quality of life, and reduction in depressive symptoms over a six-month intervention than UC group. TC group showed significant group-by-time interactions in these variables.Conclusion
Group-based Tai chi is effective in the enhancement of health-status outcomes for older Chinese adults with hypertension. 相似文献14.
Vladimira Timkova Iveta Nagyova Sijmen A. Reijneveld Ruzena Tkacova Jitse P. van Dijk Ute Bültmann 《Heart & lung : the journal of critical care》2018,47(4):371-379
Background
Social support and mastery are important aspects in the treatment of chronic diseases, however their role in connection with Obstructive Sleep Apnoea (OSA) remains unclear.Objectives
The study examined the associations between social support, mastery, sleep-related problems and functional status in untreated OSA patients.Methods
All patients in this cross-sectional study completed the Multidimensional Scale of Perceived Social Support, the Pearlin Mastery Scale, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale and the Functional Outcomes of Sleep Questionnaire. Multiple linear regression and mediation analyses were used to analyse the data.Results
Participants were 150 newly diagnosed OSA patients (Apnoea-Hypopnoea Index–AHI≥5; 68% male; mean age 48.9 ± 9.5years). Compared with social support, mastery was more strongly associated with functional status. The indirect effects of sleep-related problems on functional status via mastery varied between 17.7% and 23.3%.Conclusions
Supporting OSA patients' sense of mastery may significantly contribute to better disease management. 相似文献15.
Kenton L. Anderson Neel A. Shah Moises Gallegos I-Hui Chiang 《Heart & lung : the journal of critical care》2018,47(4):363-365
Background
A 71-year-old non-smoking female with a history of diabetes, hypertension, hyperlipidemia and end-stage renal disease presented to the emergency department for right leg pain due to an ankle fracture.Case
The patient's initial electrocardiogram (ECG) revealed ST segment elevations in the anterior leads. She denied any chest pain, shortness of breath, fatigue, lightheadedness, palpitations, nausea or diaphoresis. Her initial laboratory Troponin I resulted 35.9 ng/mL. Coronary catheterization demonstrated 99% occlusion of the left anterior descending (LAD) coronary artery. The patient had 2 drug eluting stents placed in the LAD with 10% residual stenosis.Conclusion
Although witnessing an ongoing asymptomatic ST elevation myocardial infarction (STEMI) is rare, this case highlights the importance of early revascularization when the ECG demonstrates a STEMI, even in the absence of symptoms for patients at risk for silent myocardial infarctions. 相似文献16.
Halley Ruppel Marjorie Funk Holly Powell Kennedy Christopher P. Bonafide Shu-Fen Wung Robin Whittemore 《Heart & lung : the journal of critical care》2018,47(5):502-508
Background
Customizing monitor alarm settings to individual patients can reduce alarm fatigue in intensive care units (ICUs), but has not been widely studied.Objectives
To understand ICU nurses' approaches to customization of electrocardiographic (ECG) monitor alarms.Methods
A convergent mixed methods study was conducted in 3 ICUs in 1 hospital. Data on the type and frequency of ECG alarm customization were collected from patient monitors (n=298). Nurses' customization clinical reasoning was explored through semi-structured interviews (n=27).Results
Of the 298 patients, 58.7% had ≥1 alarm(s) customized. Heart rate limits, irregular heart rate, and atrial fibrillation were the most commonly customized alarms. Interviews revealed that customization practices varied widely and were influenced by factors including clinical expertise, lack of customization education, and negative experiences.Conclusion
Alarm customization is nuanced and requires adequate support to develop safe and effective practices. The challenges identified can inform development of strategies to improve alarm customization. 相似文献17.
JiYeon Choi Jennifer H. Lingler Michael P. Donahoe Mary Beth Happ Leslie A. Hoffman Judith A. Tate 《Heart & lung : the journal of critical care》2018,47(4):401-407
Background
Few studies have longitudinally explored the experience and needs of family caregivers of ICU survivors after patients' home discharge.Methods
Qualitative content analysis of interviews drawn from a parent study that followed family caregivers of adults ICU survivors for 4 months post-ICU discharge.Results
Family caregivers (n = 20, all white, 80% woman) viewed home discharge as positive progress, but reported having insufficient time to transition from family visitor to the active caregiver role. Caregivers expressed feelings of relief during the steady recovery of family members' physical and cognitive function. However, the slow pace of improvement conflicted with their expectations. Even after patients achieved independent physical function, emotional needs persisted and these issues contributed to caregivers' anxiety, worry, and view that recovery was incomplete.Conclusion
Family caregivers of ICU survivors need information and skills to help managing patients' care needs, pacing expectations with actual patients' progress, and caregivers' health needs. 相似文献18.
Jungeun Lee Huong Q. Nguyen Monica E. Jarrett Pamela H. Mitchell Kenneth C. Pike Vincent S. Fan 《Heart & lung : the journal of critical care》2018,47(2):149-156
Background
Chronic obstructive pulmonary disease (COPD) patients experience multiple symptoms including dyspnea, anxiety, depression, and fatigue, which are highly correlated with each other. Together, those symptoms may contribute to impaired physical performance.Objectives
The purpose of this study was to examine interrelationships among dyspnea, anxiety, depressive symptoms, and fatigue as contributing factors to physical performance in COPD.Methods
This study used baseline data of 282 COPD patients from a longitudinal observational study to explore the relationship between depression, inflammation, and functional status. Data analyses included confirmatory factor analyses and structural equation modeling.Results
Dyspnea, anxiety and depression had direct effects on fatigue, and both dyspnea and anxiety had direct effects on physical performance. Higher levels of dyspnea were significantly associated with impaired physical performance whereas higher levels of anxiety were significantly associated with enhanced physical performance.Conclusion
Dyspnea was the strongest predictor of impaired physical performance in patients with COPD. 相似文献19.
Chunhua Ma 《Heart & lung : the journal of critical care》2018,47(2):136-141
Objectives
To explore whether five variables of the health belief model were factors influencing self-care behaviors in young and middle-aged adults with hypertension.Background
The self-care behaviors of young and middle-aged adults with hypertension are suboptimal in China, and the factors associated with self-care behaviors have rarely been studied in the population.Methods
A questionnaire survey was adopted in the study. 382 eligible participants were recruited from two tertiary teaching hospitals using the convenience sampling.Results
The predictors of self-care behaviors in young and middle-aged adults with hypertension included age, complications related to hypertension, perceived susceptibility, severity, benefits, barriers and self-efficacy. Five aspects of health beliefs model accounted for 47.0% of total variance.Conclusions
The perceived susceptibility, severity, benefits, barriers, and self-efficacy were key factors affecting self-care behaviors in young and middle-aged adults with hypertension. A health education program targeting improving health beliefs for the population should be developed. 相似文献20.
Robyn Gallagher Sue Randall Stella H.M. Lin Janice Smith Alexander M. Clark Lis Neubeck 《Heart & lung : the journal of critical care》2018,47(5):471-476