Article
Cardiac & Cardiovascular Systems
Jacob C. Jentzer, Nandan S. Anavekar, Yogesh N. Reddy, Dennis H. Murphree, Brandon M. Wiley, Jae K. Oh, Barry A. Borlaug
Summary: Impaired right ventricular pulmonary artery coupling has been associated with higher mortality in patients with chronic heart disease, and this association was also found in critically ill patients. Specifically, a higher TASV/RVSP ratio was linked to lower in-hospital mortality and lower 1-year mortality among hospital survivors.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Medicine, General & Internal
Carina Bethlehem, Inge T. Bootsma, Fellery De Lange, E. Christiaan Boerma
Summary: This study aimed to identify factors contributing to right ventricular dysfunction in patients undergoing cardiac surgery. The results showed that independent risk factors for a decline in right ventricular ejection fraction during surgery included preoperative use of calcium channel blocker, intraoperative fluid balance, and baseline right ventricular ejection fraction.
Article
Multidisciplinary Sciences
Eveline H. J. J. Mestrom, Tom H. G. F. Bakkes, Nassim Ourahou, Hendrikus H. M. Korsten, Paulo de Andrade Serra, Leon Montenij, Massimo Mischi, Simona Turco, R. Arthur Bouwman
Summary: Currently, there is no evidence-based criteria for decision making in the post anesthesia care unit (PACU). This study aims to assess whether including intra- and postoperative factors improves the prediction of postoperative patient deterioration and unanticipated ICU admissions.
Article
Multidisciplinary Sciences
Ryoung-Eun Ko, Sungeun Kim, Jihye Lee, Sojin Park, Daehwan Bae, Ki Hong Choi, Taek Kyu Park, Chi Ryang Chung, Jeong Hoon Yang
Summary: This study examines the clinical phenotypes of delirium in cardiac intensive care unit (CICU) patients and their relationship with clinical outcomes. The results show that delirium is common in CICU patients and is associated with increased in-hospital mortality. Septic delirium and hypoxic delirium are the most common delirium phenotypes.
Review
Medicine, General & Internal
Alessia Mattei, Alessandro Strumia, Maria Benedetto, Antonio Nenna, Lorenzo Schiavoni, Raffaele Barbato, Ciro Mastroianni, Omar Giacinto, Mario Lusini, Massimo Chello, Massimiliano Carassiti
Summary: Right ventricular (RV) dysfunction is common after cardiac surgery and is associated with adverse postoperative outcomes. The evaluation of RV function remains a challenge due to the lack of consensus on assessment criteria. Factors contributing to RV dysfunction include ischemic reperfusion injury, prolonged ischemic time, cardioprotective strategies, weaning from cardiopulmonary bypass, and preoperative risk factors. The gold standard techniques for assessing RV function are cardiac magnetic resonance imaging and hemodynamic assessment using thermodilution, while echocardiography is widely used due to its accessibility and cost-effectiveness. Clinical management strategies focus on early detection and include various drug therapies. Bridging research gaps in this field is crucial for improving clinical outcomes associated with RV dysfunction.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
David Levy, Driss Laghlam, Philippe Estagnasie, Alain Brusset, Pierre Squara, Lee S. Nguyen
Summary: In this cohort study, 2.9% of patients developed clinically significant post-operative RVF. Moreover, RVF was associated with severe adverse outcomes, including death, strokes, reintubation, and prolonged intensive care unit stay.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Anesthesiology
Caroline Holaubek, Fabian Winter, Anita Lesjak, Arezu Aliabadi-Zuckermann, Philipp Opfermann, Bernhard Urbanek, Christine Schloemmer, Mohamed Mouhieddine, Andreas Zuckermann, Barbara Steinlechner
Summary: The study aimed to identify perioperative risk factors for intensive care unit readmission and in-hospital death after cardiac surgery. Preoperative risk factors such as end-stage renal failure, arrhythmia, chronic obstructive pulmonary disease, age over 80, and high European System for Cardiac Operative Risk Evaluation II score were associated with ICU readmission. Readmitted patients had a higher mortality rate compared to nonreadmitted patients.
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
(2022)
Article
Cardiac & Cardiovascular Systems
Barry Burstein, Vidhu Anand, Bradley Ternus, Meir Tabi, Nandan S. Anavekar, Barry A. Borlaug, Gregory W. Barsness, Garvan C. Kane, Jae K. Oh, Jacob C. Jentzer
Summary: The study found that echocardiographic CPO was inversely associated with hospital mortality in unselected CICU patients, particularly among patients with increased lactate and vasopressor requirements.
AMERICAN HEART JOURNAL
(2022)
Article
Cardiac & Cardiovascular Systems
Andrew M. Young, Raymond J. Strobel, Evan Rotar, Anthony Norman, Matt Henrich, J. Hunter Mehaffey, William Brady, Nicholas R. Teman
Summary: The development of a medical emergency team (MET) can reduce mortality and complication rates after cardiac surgery, especially in non-intensive-care patients.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2023)
Review
Cardiac & Cardiovascular Systems
Andrea Montisci, Vittorio Palmieri, Jennifer E. Liu, Maria T. Vietri, Silvia Cirri, Francesco Donatelli, Claudio Napoli
Summary: The increasing number of cancer survivors is attributed to more effective therapies, but chemotherapy regimens are often toxic, especially causing cardiac damage. Mechanisms of chemotherapy-induced cardiac toxicity include direct myocyte damage, arrhythmia induction, coronary vasospasm, and accelerated atherosclerosis. Management of critically ill cancer patients with acute cardiac toxicity poses a unique challenge, as there is no etiologic therapy available and only supportive measures can be implemented.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Anesthesiology
Mitsunori Nakano, Yohei Nomura, Glenn Whitman, Marc Sussman, Stefano Schena, Ahmet Kilic, Chun W. Choi, Kei Akiyoshi, Karin J. Neufeld, Jennifer Lawton, Elizabeth Colantuoni, Atsushi Yamaguchi, Matthew Wen, Peter Smielewski, Ken Brady, Brian Bush, Charles W. Hogue, Charles H. Brown
Summary: This study characterized cerebral autoregulation during cardiac surgery and early ICU care, finding altered autoregulation metrics in the ICU that may be clinically relevant to delirium. Further investigation is needed to determine the potential benefits of autoregulation-based MAP targeting in the ICU.
BRITISH JOURNAL OF ANAESTHESIA
(2021)
Article
Medicine, General & Internal
Ah Ran Oh, Jungchan Park, Jong-Hwan Lee, Dan-Cheong Choi, Kwangmo Yang, Jin-ho Choi, Joonghyun Ahn, Ji Dong Sung, Seunghwa Lee
Summary: This study aimed to evaluate the association between the Sequential Organ Failure Assessment (SOFA) score and outcomes in patients who stayed in the intensive care unit (ICU) for less than one day after non-cardiac surgery. The results showed that a higher initial SOFA score was associated with increased three-year mortality. Additionally, worsening of the SOFA score after surgery was associated with higher three-year mortality and complications. These findings suggest that the change in SOFA score should be considered at discharge from the ICU.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
Jing-Bin Huang, Zhao-Ke Wen, Chang-Chao Lu, Jian-Rong Yang, Jun-Jun Li
Summary: This study aimed to identify the risk factors for prolonged intensive care unit (ICU) stay after cardiac surgery for infective endocarditis (IE) and to reduce the operative risk of mortality and morbidity. The results showed that factors such as male gender, age, weight, vegetation length, paravalvular leak, aortic cross-clamp time, cardiopulmonary bypass time, mechanical ventilation time, and other factors were associated with prolonged ICU stay.
Article
Cardiac & Cardiovascular Systems
Sandra Lindstedt, Snejana Hyllen
Summary: Exhaled breath particles may be used to detect cardiac failure, as patients with post-operative cardiac failure following surgery exhibit increased particle mass and flow rate compared to those without cardiac failure. Impaired cardiac function is also associated with differences in particle composition.
Article
Cardiac & Cardiovascular Systems
Manreet K. Kanwar, Kay D. Everett, Gaurav Gulati, Michael Brener, Navin K. Kapur
Summary: Cardiogenic shock is a common condition in the intensive care unit, often caused by left ventricular failure. However, right ventricular-predominant heart failure leading to shock is less recognized. This review discusses the epidemiology and mechanisms of right ventricular-predominant heart failure and explores pharmacologic and device-based approaches for its management.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2022)