Journal of Cardiac Critical Care TSS最新文献

{"title":"Beta-Adrenergic Blockade: Is It the Prudent Choice against Sympathetic Overdrive in Patients with Hypertension or Heart Failure?","authors":"H. Chopra, A. Pancholia, Bhupen N. Desai, A. Sinha, Dhammdeep C. Dabhade, S. Newale","doi":"10.1055/s-0042-1759804","DOIUrl":"https://doi.org/10.1055/s-0042-1759804","url":null,"abstract":"Abstract The development of hypertension and heart failure is correlated with the hyperactivation of the sympathetic nervous system. Beta-blockers are often considered a good therapeutic option in such clinical scenarios. However, the choice of β-blocker is a concern because of certain aspects like associated metabolic disturbances with their usage. Metoprolol has been reported to have the potential to alleviate sympathetic overdrive in patients with hypertension and heart failure. S-Metoprolol is the chirally pure β-blocker with favorable pharmacological features, improved safety profile, and allied clinical advantages versus racemic metoprolol; given this, can it be an effective therapeutic option against sympathetic overdrive in patients with hypertension and/or heart failure is not fully recognized yet. In this review, we attempted to discuss the current facts around sympathetic overdrive linked with hypertension as well as heart failure and pertaining pharmacological intervention with a focus on β-blockers in these clinical situations with an emphasis on the likely beneficial role of S-metoprolol.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"1 1","pages":"206 - 209"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81991257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology and Management of Hypercoagulation in Infectious Diseases","authors":"A. Tandayam, MujtabaHussain Naqvi Syed, G. Kumar","doi":"10.1055/s-0042-1757370","DOIUrl":"https://doi.org/10.1055/s-0042-1757370","url":null,"abstract":"Numerous systemic infections may have hypercoagulation as one of the complications, which may range from asymptomatic presentation of elevation of biochemical markers of coagulation such as that of fibrin and thrombin generation, to a much severe, symptomatic, life-threatening, disseminated intravascular coagulation (DIC), which results in the formation of thrombi in the microvasculature of various organs. This phenomenon contributes to increase in morbidity and mortality in various infectious diseases. The current review discusses various mechanisms of hypercoagulation during infections such as tissue factor activation, endothelial cell activation, inhibition of physiological anticoagulant pathways, and fibrinolysis inhibition. The review also discusses pathophysiological changes in the coagulation system and its management in the recent pandemic of COVID-19. The article also discusses role of various parenteral and oral anticoagulants in the management of infectious diseases. The review provides clinical data on various anticoagulants used during hospitalization and extended prophylaxis for the management of venous thromboembolism in various infections.\u0000 Methodology Because this is a review of published literature and no humans or animals were involved, ethical committee approval was not required and patient consent was not required.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"125 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83998048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Cerebral Oximetry in Extracorporeal Membrane Oxygenation","authors":"N. Shastri","doi":"10.1055/s-0042-1757393","DOIUrl":"https://doi.org/10.1055/s-0042-1757393","url":null,"abstract":"Cerebral oximetry, which is based on near-infrared spectroscopy (NIRS) technology, is an optical technique that allows for noninvasive and continuous monitoring of brain oxygenation by determining cerebral tissue blood oxygen saturation. Many research and observational studies were performed with neonates using various types of NIRS/cerebral oximetry monitors. However, no food and drug administration (FDA) approved-cerebral oximeter is available for neonates. Successful validation of cerebral oximetry for the FDA has been done in human adult volunteer studies under protocols in which jugular bulb and arterial blood samples were obtained under different levels of fractional inspired oxygen levels.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91075233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenic Artery Pseudoaneurysm—A Concern for the Anesthesiologist","authors":"Ankita Singh, N. Makhija, Shruti K. Somani, M. Verma, Sanjeev Kumar","doi":"10.1055/s-0042-1756472","DOIUrl":"https://doi.org/10.1055/s-0042-1756472","url":null,"abstract":"Pseudoaneurysms as compared with aneurysms lack a true wall and have a higher propensity of rupture. Visceral artery pseudoaneurysms are uncommon and are life-threatening. We, hereby, report anesthetic management of a rare case of splenic artery pseudoaneurysm that accompanied the dilatation of aorta from its origin extending up to its bifurcation.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78947510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Analysis of Arterial Carbon Dioxide Level and Arterial pH Level at the Time of Initiation of Respiratory ECMO and Outcome","authors":"Pranay Oza, Rajendra Umbarkar, V. Goyal, P. Shukla","doi":"10.1055/s-0042-1757395","DOIUrl":"https://doi.org/10.1055/s-0042-1757395","url":null,"abstract":"\u0000 Introduction Respiratory extracorporeal membrane oxygenation (ECMO) is well established and its popularity has increased during coronavirus disease 2019 (COVID-19) time. The efficacy of ECMO has been proved in refractory respiratory failure with varied etiology. More than 85,000 respiratory ECMO cases (neonatal, pediatric, adult) registered as per Extracorporeal Life support Organization (ELSO) statistics April 2022 report, with survived to discharge or transfer ranging from 58 to 73%. Early initiation of ECMO is usually associated with shorter ECMO run and better outcome. Many patient factors have been associated with mortality while on ECMO. Pre-ECMO patient pH and arterial partial pressure of carbon dioxide (paCO2) have been associated with poor outcome. We designed a retrospective study from a single tertiary care center and analyzed our data of all respiratory ECMO (neonatal, pediatric, and adult) to understand the effect of pre ECMO, paCO2, and arterial pH to ECMO outcome.\u0000 Methods It is a retrospective analysis of data collected of patients with acute respiratory failure managed on ECMO from January 2010 to December 2021. Pre-ECMO (1–6 hours before initiation), paCO2, and arterial pH level were noted and analyzed with primary and secondary outcome. Primary outcome goal was survivor and discharged home versus nonsurvivor, while secondary goal was the number of ECMO days and incidence of neurological complications. The statistical analysis was done for primary outcome and incidences of neurological complications and p-value obtained by using chi-squared method. Meta-analysis was done by classifying the respiratory ECMO cases in three major category—COVID-19, H1N1 non-COVID-19, and H1N1 respiratory failure.\u0000 Results The total 256 patients of respiratory failure were treated with ECMO during specified period by Riddhi Vinayak Multispecialty Hospital ECMO team. Data analysis of 251 patients (5 patients were transferred for lung transplant, hence been not included in study) done. Patients were divided on the basis of pH level less than 7.2 and more than 7.2 and analyzed for primary and secondary outcome. Similarly, patients were divided on the basis of paCO2 level of less than 45 and more than 45.Patient with pre-ECMO pH level more than 7.2 has statistically better survived extracorporeal life support (ECLS) (p-value: 0.008) and survival to discharge home (p-value: 0.038) chances. Pre-ECMO paCO2 level of less than 45 also showed better survival chance of survived ECLS (46.67 vs. 36.02) and survived to discharge home (42.22 vs. 31.06) but not statistically significant (p-value: 0.15 and 0.18, respectively). There was no significant difference in average number of ECMO days in patient survived to discharge home with paCO2 less than 45 and more than 45 (15.7 vs. 11.1 days), and also in pH more than 7.2 and pH less than 7.2 (15.8 vs. 11.6). The incidence of neurological complications was also found lower in patient with pH more than 7.2 (7.5 vs. 1","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86573934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papillary Muscle Rupture following Acute Myocardial Infarction","authors":"Ajmer Singh, C. Nanda, Y. Mehta","doi":"10.1055/s-0042-1759803","DOIUrl":"https://doi.org/10.1055/s-0042-1759803","url":null,"abstract":"Abstract Rupture of a papillary muscle after acute myocardial infarction is a rare but potentially fatal complication. It can lead to acute, severe mitral regurgitation, pulmonary edema, cardiogenic shock, and death. Immediate surgical intervention in the form of mitral valve repair/replacement with concomitant coronary revascularization can reduce mortality. We herein report such a case who presented with cardiogenic shock and made a successful outcome after emergent surgery.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"60 1","pages":"230 - 232"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87114903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plugging the Unplugged: Simultaneous Percutaneous Closure of Anterior Mitral Leaflet and Aortic Root Perforation","authors":"C. Nanda, Sudipto Banerjee, Y. Mehta","doi":"10.1055/s-0042-1756471","DOIUrl":"https://doi.org/10.1055/s-0042-1756471","url":null,"abstract":"There are very few case reports of percutaneous device closure of anterior mitral leaflet perforation. We describe here a case of simultaneous percutaneous closure of aortic root perforation and anterior mitral perforation. These cases are challenging as they are presently done in high-risk patients with no guidelines described to date.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79686661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Preoperative Plasma Endothelin-1 Level Influences the Postoperative Events in Patients Undergoing Coronary Artery Bypass Grafting (CABG)? Revisiting Endothelin-1 Molecule in CABG Patients","authors":"Minati Choudhury, M. Hote, P. Kapoor, S. Saini, U. Kiran","doi":"10.1055/s-0042-1757362","DOIUrl":"https://doi.org/10.1055/s-0042-1757362","url":null,"abstract":"Endothelin-1 (ET-1) is a powerful physiological vasoconstrictor release in response to endothelial injury. Increased synthesis of endothelin is associated with myocardial ischemia and reperfusion injury. The normal level varies between 0.2 and 18.5 pg/mL that maintains normal vascular homeostasis. We hypothesized that there exists a correlation between ET-1 and clinical outcome in patient undergoing elective coronary artery bypass grafting (CABG) surgery under cardiopulmonary bypass.Fifty-eight patients undergoing elective on-pump CABG were enrolled in the study. Blood sample for plasma ET-1 was taken before anesthesia induction. The median ET-1 level was 5 pg/mL (range: 0.6–30.33 pg/mL). The inotropic and intraaortic balloon pump requirement was significantly higher among patients having baseline ET-1 level more than 14.24pg/mL (p = 0.001in each case). A similar finding was observed in the duration of mechanical ventilation, intensive care unit stay, and duration of hospital stay (r = 0.68, p = 0.000; r = 0.58, p = 0.000; and r = 0.61, p = 0.000 respectively). The occurrence of complications was also more in individuals with higher baseline ET-1 level. The p-value was significant for occurrence infection, arrhythmia, renal and respiratory problems as observed in postoperative period by using Mann–Whitney U test.This study concludes that higher level of preoperative ET-1 levels correlates well to adverse clinical outcome in patients undergoing on-pump CABG surgery, so herein it can be used as a single independent parameter to predict postoperative outcome.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"172 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79514265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redo Mitral Valve Replacement Using St. Jude Medical Mechanical Prosthesis via Transseptal Approach in a Patient with Degenerated Mitral Epic Bioprosthesis: A Video Presentation","authors":"S. Goja, Niwin George, L. Sankhyan, Sumanth Raghuprakash, Shradha Gupta, Shweta Sharma, P. Kapoor, U. Chowdhury","doi":"10.1055/s-0042-1757365","DOIUrl":"https://doi.org/10.1055/s-0042-1757365","url":null,"abstract":"A 58-year-old male patient with degenerated St. Jude Epic mitral bioprosthesis underwent successful mitral valve replacement using 29 mm St. Jude Medical mechanical prosthesis. Case history presented here to prevent organ injury via a transeptal approach for a degenerated epic bioprosthesis.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75345749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ankle Block for Acute Pain Management in a Patient with Mitral Valve Prolapse and Infective Endocarditis with Dry Gangrene of Toes","authors":"Sambhunath Das, M. Prakash, Vishnu Anandan","doi":"10.1055/s-0042-1759808","DOIUrl":"https://doi.org/10.1055/s-0042-1759808","url":null,"abstract":"Abstract Ankle block represents a regional anesthesia technique to provide anesthesia for the procedures related to the foot. It is mainly used as a sole anesthesia technique or as an adjunct for postoperative pain relief in foot operations. It is an infiltrative block with advantages like being technically easier, safe, having minimal side effects, and having a high success rate. Management of postoperative pain is an essential service provided by a cardiac anesthesiologist to patients undergoing operative procedures, but the knowledge in providing regional anesthesia may be used beyond the operating room or critical care unit. In the present case, we administered an ankle block to alleviate the pain in case of dry gangrene.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"57 1","pages":"233 - 234"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89143427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}