Heart & lung : the journal of critical care
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Multicenter Study
The number of mechanically ventilated ICU patients meeting communication criteria.
(1) Estimate the proportion of mechanically ventilated (MV) intensive care unit (ICU) patients meeting basic communication criteria who could potentially be served by assistive communication tools and speech-language consultation. (2) Compare characteristics of patients who met communication criteria with those who did not. ⋯ We estimate that half of MV patients in the ICU could potentially be served by assistive communication tools and speech-language consultation.
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Review Meta Analysis
The prognostic significance of troponin elevation in patients with sepsis: a meta-analysis.
To confirm the association between troponin elevation in patients with sepsis and mortality. ⋯ Troponin elevation in patients with sepsis confers poorer prognosis and is a predictor of mortality. Further studies are needed to see if more aggressive treatment of this subset of patients, or utilizing new therapeutic approaches will improve mortality.
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Evaluate time to treatment (TT) in suspected acute coronary syndrome (ACS) patients in the Emergency Department (ED) in Pakistan. ⋯ Findings warrant exploring interventions to improve TT for ACS care in resource-limited settings.
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Case Reports
Congenital long QT syndrome: severe torsades de pointes provoked by epinephrine in a digenic mutation carrier.
Congenital Long QT Syndrome (LQTS) is a potentially lethal cardiac channelopathy characterized by prolongation of the corrected QT (QTc) interval on the surface electrocardiogram. The hallmark phenotypic features are syncope, seizure or sudden death, however most of the mutation carriers are asymptomatic and their risk for arrhythmias such as Torsade de pointes (TdP) are low. We report a case of Long QT syndrome with a corrected QT of 520 ms. ⋯ Epinephrine testing was performed for clinical risk stratification leading to Torsades de pointes during recovery phase which required defibrillation. Genetic testing discovered two pathogenic heterozygous mutations in two different LQT genes (SCN5A and KCNQ1). We propose a calcium homeostasis mechanism for the interaction of both mutations that exaggerated the phenotype, while each mutation by itself is causing a relatively modest phenotype.
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Post-operative nausea and vomiting (PONV) is a common and distressing complication following cardiac surgery. Therefore, our primary objective was to explore the predictors of severe PONV in the cardiac surgery population. ⋯ A specific PONV risk assessment tool may be useful for predicting those at highest risk following cardiac surgery. Further research is required to identify strategies to reduce PONV.