scholarly journals Neurological dysfunction after cardiac surgery and cardiac intensive care admission: A narrative review part 1: The problem; nomenclature; delirium and postoperative neurocognitive disorder; and the role of cardiac surgery and anesthesia

2020 ◽  
Vol 23 (4) ◽  
pp. 383
Author(s):  
MukulC Kapoor
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Narrative Review ◽  
Neurological Dysfunction ◽  
Neurocognitive Disorder ◽  
Intensive Care Admission ◽  
Cardiac Intensive Care

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

699 Cardiac Arrest After Cardiac Surgery : Role of Simulation for the Intensive Care Team Performance

2012 ◽  
Vol 28 (5) ◽  
pp. S366 ◽  
Author(s):  
Y. Lamarche ◽  
M. Pagé ◽  
M. Laflamme ◽  
I. El-Hamamsy ◽  
D. Bouchard ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Team Performance ◽  
Care Team

Psychological distress and intensive care unit stay after cardiac surgery: The role of illness concern.

2015 ◽  
Vol 34 (3) ◽  
pp. 283-287 ◽  
Author(s):  
Lydia Poole ◽  
Tara Kidd ◽  
Elizabeth Leigh ◽  
Amy Ronaldson ◽  
Marjan Jahangiri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Psychological Distress ◽  
Intensive Care Unit Stay

scholarly journals Ultrasound in critical care

2020 ◽  
Author(s):  
Saima Rashid ◽  
Muhammad Faisal Khan ◽  
Rajkumar Rajendram
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
21St Century ◽  
Potential Role ◽  
Point Of Care ◽  
Narrative Review ◽  
Point Of Care Ultrasound ◽  
The 1950S

Ultrasound (US) was introduced in the 1950s and since then its use has increased exponentially. This has been facilitated by significant improvement in the probe technology, increasing access to portable machines and better understanding of lung, heart, abdominal and vascular US. Use of critical care US (CCUS) is now extremely common. It is important for frontline physicians who must make appropriate and timely decisions within seconds. It is safe, convenient and readily available in many centers. The concept of point of care ultrasound (POCUS) differs from US screening by a radiologist or sonographer. It is, rapid focused and goal-orientated. Despite its major limitation, e.g. operator dependence, bedside CCUS can be used for an ever-increasing range of indications. This narrative review will describe the potential role of CCUS as the replacement for the stethoscope in the 21st century and the limitations which must be overcome to achieve this. Received: 3 Nov 2018Reviewed & Accepted: 10 Nov 2018 Citation: Rashid S, Khan MF, Rajendram R. Ultrasound in critical care. Anaesth Pain & Intensive Care 2018;22 Suppl 1:S160-S163

The Impact of Dedicated Cardiac Intensive Care Units on Outcomes in Pediatric Cardiac Surgery: A Virtual Pediatric Systems Database Analysis

2020 ◽  
Author(s):  
Dayanand N. Bagdure ◽  
Jason W. Custer ◽  
Cortney B. Foster ◽  
William C. Blackwelder ◽  
Vladimir Mishcherkin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Mortality Rate ◽  
Intensive Care Units ◽  
Risk Category ◽  
Database Analysis ◽  
Cardiac Intensive Care ◽  
Outcomes For Children ◽  
The Impact ◽  
Risk Categories

AbstractCare of children undergoing cardiac surgery occurs in dedicated cardiac intensive care units (CICU) or mixed intensive care units. We analyzed data from Virtual Pediatric Systems (VPS, LLC) database (2009–2014) for children < 18 years of age undergoing cardiac surgery, classified according to Society of Thoracic Surgery–European Association of Cardiothoracic Surgery (STS-EACTS) risk category. We had 25,052 (52%) patients in 53 mixed units (mortality rate, 2.99%), and 22,762 (48%) patients in 19 dedicated CICUs (mortality rate, 2.62%). There was a direct relationship between STS-EACTS risk category and death rate in both units. By multivariable logistic and linear regression, there was no difference in mortality between mixed unit and CICU death rates within STS-EACTS risk categories. We found no difference in outcomes for children undergoing cardiac surgery based on the unit type (dedicated CICU or mixed unit).

Applying Educational Theory to Interdisciplinary Education in Pediatric Cardiac Critical Care

2019 ◽  
Vol 10 (6) ◽  
pp. 742-749
Author(s):  
Mary E. McBride ◽  
Melvin C. Almodovar ◽  
Amy R. Florez ◽  
Annette Imprescia ◽  
Lillian Su ◽  
...  
Keyword(s):  
Intensive Care ◽  
Interdisciplinary Education ◽  
Intensive Care Society ◽  
International Meeting ◽  
Cardiopulmonary Interactions ◽  
Curricular Design ◽  
Simulation Based ◽  
Cardiac Intensive Care ◽  
Cardiac Critical Care

At the 14th Annual International Meeting for the Pediatric Cardiac Intensive Care Society, the authors presented a simulation workshop for junior multidisciplinary providers focused on cardiopulmonary interactions. We provide an overview of educational theories of particular relevance to curricular design for simulation-based or enhanced activities. We then demonstrate how these theories are applied to curriculum development for individuals to teams and for novice to experts. We review the role of simulation in cardiac intensive care education and the education theories that support its use. Finally, we demonstrate how a conceptual framework, SIMZones, can be applied to design effective simulation-based teaching.

Abstract NS5: Implementing NICE (Neurological Intensive Care Evaluation) in the CVICU to Identify Neurological Dysfunction More Rapidly in Post-Operative Cardiac Surgery Patients

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Taylor Esdale ◽  
Grace Davis ◽  
Brooke Harvey ◽  
Heather Lachiewicz ◽  
Jennifer Brecher ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Assessment Tool ◽  
Artery Bypass ◽  
Standard Of Care ◽  
Ease Of Use ◽  
Neurological Dysfunction ◽  
Fiscal Year ◽  
Neurological Intensive Care ◽  
Care Evaluation

Background: Piedmont Atlanta Hospital identified cardiothoracic surgical (CTS) outcome metrics that were not meeting benchmarks established by the Society for Thoracic Surgeons (STS). Post-operative permanent stroke occurred in 1.303% (8 out of 616 cases) of coronary artery bypass-only patients at Piedmont Atlanta Hospital (PAH) during Fiscal Year 2015. The STS benchmark for all hospitals is 1.3%. Initially, the goal was to reduce the number of post-operative strokes to the standard of care but while reviewing this data, it was noted that there was significant delay in discovering the occurrence of stroke in this patient population. Traditional neurological assessments and stroke scales are difficult to apply to post-operative open heart patients due to intubation, variation in anesthesia recovery times, and the effects of pain management medications. To improve patient outcomes, PAH researched alternatives to standard post-operative neurological assessments to rapidly identify strokes and potential interventional candidates, ultimately reducing the frequency of disabling stroke. Method: A CTS Stroke Pathway was created that included the Neurologic Intensive Care Evaluation (NICE), a novel assessment tool performed by the critical care nurse. NICE was chosen because of the ease of use on post-anesthesia patients. Neurological state was assessed based on the ability to complete one-step commands up to six hours post-op. Results: Prior to NICE being implemented, stroke symptoms were discovered on average 40 hours from last known time well (LKTW). After NICE being implemented, Code Strokes (notification of neurological dysfunction) were initiated on average four hours from patients LKTW. In the first month of utilizing the NICE tool, one of three post-operative stroke patients was able to be transferred to a comprehensive stroke center for a mechanical thrombectomy. Conclusion: Implementing NICE as the standard neurological assessment for immediate post-operative cardiac surgery patients significantly reduced the time to identify neurological changes indicating a stroke. This may lead to more rapid treatment or intervention, reducing the post-operative rate of permanent stroke.

The role of magnetic resonance imaging in the diagnosis of brachial plexopathy in a COVID-19 patient

2020 ◽  
pp. 1-4
Keyword(s):  
Magnetic Resonance Imaging ◽  
Intensive Care ◽  
Magnetic Resonance ◽  
Brachial Plexus ◽  
Early Recognition ◽  
Brachial Plexopathy ◽  
Resonance Imaging ◽  
Intensive Care Admission ◽  
Mri Protocol

Severe COVID-19 infection can lead to acute respiratory distress syndrome (ARDS) requiring intensive care admission. Mechanically ventilated patients are commonly managed by being positioned in a prone ‘swimmer’s position’. However, this position can lead to a variety of potential complications not related to the illness, including stretching of the brachial plexus resulting in nerve damage. Brachial plexopathy is an important consideration in all patients stepped down from prolonged prone ventilation. This is to prevent possible long-term numbness and weakness in the affected arm which may require intensive physiotherapy. The role of magnetic resonance imaging is particularly useful in visualizing the brachial plexus and providing an accurate diagnosis. Early recognition and prompt imaging is recommended to reduce the incidence and severity of brachial plexopathy, particularly in the wake of a second COVID-19 wave. We report a case of brachial plexopathy in a 54-year-old male following intensive care admission and the relevant MRI protocol and findings which highlight this pathology.

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