Heart & lung : the journal of critical care
-
To summarize the current evidence for adaptive servo ventilation (ASV) in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF) and advance a research agenda and clinical considerations for ASV-treated CSR-CSA in HF. CSR-CSA in HF is associated with higher overall mortality, worse outcomes and lower quality of life (QOL) than HF without CSR-CSA. Five databases were searched using key words (n = 234). ⋯ ASV is not recommended for CSR-CSA in HF. It is important to continue to refer HF patients for sleep evaluation to clearly discern OSA from CSR-CSA. Symptom management research, inclusive of objective and subjective outcomes, in CSR-CSA in HF adults is needed.
-
Randomized Controlled Trial
A randomized controlled pilot trial to improve advance care planning for LVAD patients and their surrogates.
To examine feasibility, acceptability and preliminary effects of an advance care planning (ACP) intervention, SPIRIT-HF, in LVAD patients and their surrogates. ⋯ SPIRIT-HF is feasible and acceptable. Results will inform future trials.
-
Comparative Study
Automatic assessment of cardiac load due to acute pulmonary embolism: Saddle vs. central and peripheral emboli distribution.
Changes in cardiac chambers' volumes in relations to different distributions of pulmonary embolism (PE) have not been investigated. ⋯ Automatic volumetric analysis of diagnostic CTPAs provides rapid tool which can discriminate between cardiac responses in saddle, central or peripheral PE.
-
Review Case Reports
Aminocaproic acid for the management of bleeding in patients on extracorporeal membrane oxygenation: Four adult case reports and a review of the literature.
Extracorporeal membrane oxygenation (ECMO) is associated with a significant risk of bleeding and thrombosis. Despite high rates of bleeding and bleeding-related mortality in patients on ECMO, there is little evidence available to guide clinicians in the management of ECMO-associated bleeding. ⋯ In patients on ECMO with evidence of fibrinolysis, aminocaproic acid may be an effective option to control bleeding and to stabilize clot formation.
-
Observational Study
Retrospective report of contraindications to extracorporeal membrane oxygenation (ECMO) among adults with acute respiratory distress syndrome (ARDS).
To determine the incidence of contraindications to extracorporeal membrane oxygenation (ECMO) among adults with acute respiratory distress syndrome (ARDS) and assess the impact of contraindications on the number of patients receiving ECMO (case volume). ⋯ Application of relative contraindications may greatly affect ECMO case volumes.