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Tag: Cardiovascular

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SCCM Pod-128 Patient Management After Cardiac Surgery

Anthony Carlese, MD, DO, discusses management of the patient after cardiac surgery, specifically his approach to caring for patients in the ICU who have just undergone coronary artery bypass surgery and the different situations and that he encounters.


Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19

From Critical Care Explorations The authors report three cases of healthy young adults diagnosed with severe acute respiratory syndrome-CoV-2 related (MIS-A).


In COVID-19 Patients Who Suffer In-Hospital Cardiac Arrest, Cardiopulmonary Resuscitation Outcomes May Be Impacted by Arrest Etiology and Local Pandemic Conditions

From Critical Care Explorations The authors describe outcomes after cardiopulmonary resuscitation for in-hospital cardiac arrest in two COVID-19 patient cohorts.


Concise Critical Appraisal: Vasopressin and Methylprednisolone for In-Hospital Cardiac Arrest

Although several trials have examined in-hospital cardiac arrest (IHCA), only two trials in the past decade have examined the use of vasopressin and glucocorticoids for IHCA. Both trials found improved survival and favorable neurologic outcome with a vasopressin-epinephrine-methylprednisolone combination. Because of a lack of additional supporting evidence, neither the American nor European international guidelines have recommended this combination for IHCA. This Concise Critical Appraisal examines an article by Andersen et al that attempted to validate the results of these trials.
 


Altered Heart Rate Variability Early in ICU Admission Differentiates Critically Ill Coronavirus Disease 2019 and All-Cause Sepsis Patients

From Critical Care Explorations  In this descriptive statistical study, heart rate variability measures were found to be statistically different across critically ill patients infected with severe acute respiratory syndrome coronavirus 2 and distinct from bacterial sepsis.


Concise Critical Appraisal: Epinephrine Dosing Intervals on Outcomes From Pediatric In-Hospital Cardiac Arrest

The average annual incidence of pediatric in-hospital cardiac arrest (IHCA) has recently been estimated at more than 15,000 cases.1 Survival rates for pediatric patients who have had pulseless cardiac arrest have remained below 50% for the past decade.2,3 The American Heart Association currently recommends epinephrine, the cornerstone medication for cardiac arrest, dosed every 3 to 5 minutes in adult and pediatric cardiac arrest, although there is conflicting evidence about whether this is the best interval.4,5 Epinephrine is believed to acutely increase coronary perfusion pressure by increasing diastolic blood pressure (DBP).


Editorial: Coronavirus Disease 2019: There Is a Heart Between the Lungs

From Critical Care Medicine. This Editorial was written in response to the article by Chotalia et al. “Right Ventricular Dysfunction and Its Association With Mortality in Coronavirus Disease 2019 Acute Respiratory Distress Syndrome.”


A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients

From Critical Care Explorations.  In-hospital cardiac arrest survival among coronavirus disease 2019 patients has been reported to range from 0% to 12% -- significantly lower than reported prepandemic in-hospital cardiac arrest survival rates of approximately 20% to 25% in the United States for non–coronavirus disease 2019 patients. In this multi-center study, the authors report a 22% survival to discharge after in-hospital cardiac arrest in coronavirus disease 2019 patients, a survival rate similar with before the coronavirus disease 2019 pandemic.


Acute Cardiac Injury in Coronavirus Disease 2019 and Other Viral Infections—A Systematic Review and Meta-Analysis

From Critical Care Medicine. In this review article, the authors compared the rates of cardiac injury by angiotensin converting enzyme-2–binding viruses from viruses that do not bind to angiotensin-converting enzyme-2.


Letter to the Editor: Questioning the Futility of Cardiopulmonary Resuscitation in Patients With Severe Coronavirus Disease 2019

From Critical Care Medicine. This online letter to the editor was written in response to " Is Cardiopulmonary Resuscitation Futile in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest?" by Shah et al.


Letter to the Editor: Cardiopulmonary Resuscitation in Coronavirus Disease 2019: Far from Futile

From Critical Care Medicine. This online letter to the editor was written in response to " Is Cardiopulmonary Resuscitation Futile in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest?" by Shah et al.


Online Letter to the Editor: Resuscitation and Coronavirus Disease 2019: A Reappraisal

From Critical Care Medicine. This online letter to the editor was written in response to the article “Is Cardiopulmonary Resuscitation Futile in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest? By Shah et al.


Online Letter to the Editor: Judging Futility of Resuscitation Attempts for Coronavirus Disease 2019 Patients Requires Better Time Data

From Critical Care Medicine. This online letter to the editor was written in response to the article “Is Cardiopulmonary Resuscitation Futile in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest? By Shah et al.


A Systematic Review of the Incidence and Outcomes of In-Hospital Cardiac Arrests in Patients With Coronavirus Disease 2019

From Critical Care Medicine. The authors investigated the incidence, characteristics, and outcomes of in-hospital cardiac arrest in patients with coronavirus disease 2019 and describe the characteristics and outcomes for patients with in-hospital cardiac arrest within the ICU, compared with non-ICU patients with in-hospital cardiac arrest.


Cardiovascular Disease and Severe Hypoxemia Are Associated With Higher Rates of Noninvasive Respiratory Support Failure in Coronavirus Disease 2019 Pneumonia

From Critical Care Explorations. The authors describe outcomes with high-flow oxygen delivered through nasal cannula and noninvasive positive pressure ventilation in coronavirus disease 2019 acute hypoxemic respiratory failure and identify individual factors associated with noninvasive respiratory support failure.


Early Percutaneous Tracheostomy in Coronavirus Disease 2019: Association With Hospital Mortality and Factors Associated With Removal of Tracheostomy Tube at ICU Discharge. A Cohort Study on 121 Patients

From Critical Care Medicine

This study shows how early percutaneous tracheostomy was safe and effective in coronavirus disease 2019 patients, giving a good chance of survival and of weaning from tracheostomy cannula at ICU discharge.


Editorial: Coronavirus Disease 2019 Acute Respiratory Failure: Almitrine Drug Resuscitation or Resuscitating Patients by Almitrine?

From Critical Care Medicine

In this editorial, the author discusses the seeming benefits of using almitrine for severe hypoxia in patients with coronavirus disease 19 induced acute respiratory distress syndrome.


Editorial: Cardiopulmonary Resuscitation in Coronavirus Disease 2019: Rebalancing Risk, Reward, and Autonomy

From Critical Care Medicine

In this editorial, the authors discuss the risks of healthcare professionals performing cardiopulmonary resuscitation on coronavirus disease 2019 patients.


Letter to the Editor: Caution Is Needed When Reporting or Pooling the Prevalence of Venous Thromboembolism in Critically Ill Coronavirus Disease 2019 Patients

From Critical Care Medicine

In this Letter to the Editor, the author discusses the difficulties to ascertain in ICU settings the exact VTE incidence, incidence rate, or prevalence due to various reasons, including the absence of uniform screening at ICU admission to exclude patients with prior VTE, absence of systematic assessment with varying screening guided by clinicians’ suspicion, and varying follow-up time. In addition, the burden of venous thromboembolism in critically ill patients is discussed.


Is Cardiopulmonary Resuscitation Futile in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest?

From Critical Care Medicine

The authors describe the characteristics and outcomes of in-hospital cardiac arrest in coronavirus disease 2019 patients in rural Southwest Georgia.


Concise Critical Appraisal: ARREST Trial: ECMO Versus Advanced Cardiac Life Support

The ARREST Trial compared extracorporeal membrane oxygenation (ECMO)-facilitated resuscitation to advanced cardiac life support (ACLS) treatment in patients with out-of-hospital cardiac arrest (OHCA). This month’s Concise Critical Appraisal takes a deep dive into the trial, published in The Lancet.


What is the time frame for placing vascular catheters in these patients for administration of vasoactive drugs?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 9, 2020.


Have you become more aggressive in placing arterial lines in these patients when you might have only monitored pulse oximetry in the past?

Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on September 9, 2020.


Letter to the Editor: Prevalence and Clinical Correlates of Echo-Estimated Right and Left Heart Filling Pressures in Hospitalized Patients With Coronavirus Disease 2019

From Critical Care Explorations In this Letter to the Editor, the authors discuss their study in which they hypothesized that a significant proportion of coronavirus disease 2019 patients has evidence of pulmonary hypertension associated with elevated left heart filling pressure on transthoracic echocardiography.


SCCM Pod-423 Coagulopathy in COVID-19 Patients

COVID-19 is associated with a high prevalence of coagulopathy and venous thromboembolism. Host B. Kyle Enfield, MD, FCCM, talks with Jerrold H. Levy, MD, FAHA, FCCM, about what clinicians need to know about this serious problem and how it impacts care delivery (Iba et al. Crit Care Med. 2020;48:1358-1364).


Hypotension: Non-ICU Emergency Cards

This resource details how manage hypotension. This is SCCM curated COVID-19 microlearning content.


Concise Critical Appraisal: Epinephrine Versus Norepinephrine for Cardiogenic Shock

Levy et al (J Am Coll Cardiol. 2018;72:173-182) conducted a prospective, double-blind, multicenter RCT comparing epinephrine to norepinephrine in the setting of CS in patients who underwent AMI treated with percutaneous coronary intervention.


Concise Critical Appraisal: Epinephrine in Out-of-Hospital Cardiac Arrest

Perkins et al (N Engl J Med. 2018;379:711-721) set out to examine the effects of epinephrine during OHCA.