Heart & lung : the journal of critical care
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To describe LVAD patients' and surrogates' experiences with, and perspectives on SPIRIT-HF, an advance care planning (ACP) intervention. ⋯ An understanding patient and surrogate perspectives may inform clinicians' approach to ACP discussions.
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Multicenter Study
Clinical outcomes in overweight heart transplant recipients.
Few studies have examined the impact of patient weight on heart transplant (HT) outcomes. ⋯ Overweight HT patients had better survival, but more rejections, CAV, and diabetes. Non-overweight HT patients had worse survival, plus more re-hospitalization time, lymphoma, and renal dysfunction.
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The purpose of this study was to investigate the association between respiratory function and electrocardiogram (ECG) characteristics in patients with chronic obstructive pulmonary disease (COPD), and to identify the ECG results that indicate possible COPD. ⋯ Low voltage in lead І (QRS less than 0.54 mV) is an important criterion in detecting COPD.
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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.
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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.