Chest
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It is estimated that 350,000 people suffer a cardiac arrest each year in the United States, with one-half occurring out-of-hospital and the other half in-hospital. Overall survival is < 10% and has not changed significantly for decades. CPR is the umbrella term for attempts to restore organized cardiac contractility and functional blood flow. ⋯ In addition, a greater emphasis has been placed on quality of CPR, with the need to minimize interruptions, the reordering of CPR priorities to place chest compressions before ventilations, and the need for comprehensive postarrest care that includes both targeted temperature and hemodynamic management. Whether a cardiac arrest occurs out-of-hospital or in-hospital, the basic approach to CPR and postarrest care is identical. Documentation should be performed in a standardized fashion, using a consensus set of data elements known as the Utstein format, and can contribute to quality improvement, research, and billing efforts.
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An important consequence of sleep-disordered breathing (SDB) is excessive daytime sleepiness (EDS). EDS often predicts a favorable response to treatment of SDB, although in the setting of cardiovascular disease, particularly heart failure, SDB and EDS do not reliably correlate. Atrial fibrillation (AF) is another highly prevalent condition strongly associated with SDB. We sought to assess the relationship between EDS and SDB in patients with AF. ⋯ Despite a high prevalence of SDB in this population with AF, most patients do not report EDS. Furthermore, EDS does not appear to correlate with severity of SDB or to accurately predict the presence of SDB. Further research is needed to determine whether EDS affects the natural history of AF or modifies the response to SDB treatment.
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Multicenter Study Comparative Study
Portopulmonary hypertension: a report from the US-based REVEAL Registry.
We evaluated survival and hospitalization rates in patients with group 1 portopulmonary hypertension (PoPH) in the Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension Disease Management (REVEAL Registry). ⋯ Patients with PoPH had significantly poorer survival and all-cause hospitalization rates compared with patients with IPAH/FPAH, despite having better hemodynamics at diagnosis. Further studies should investigate such outcomes and differences in treatment patterns.