Heart & lung : the journal of critical care
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While heart failure (HF) in older adults is associated with fall risk, little is known about this in the U.S. ⋯ Community-dwelling older adults with HF and functional difficulties have a higher fall risk than those without HF, indicating that fall prevention programs should be developed, tested, and implemented for this population.
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Pulse oximeters, clinically used to measure oxygen saturation (SpO2), rely on adequate perfusion of the tissues over which they are placed. Heart failure (HF) patients can have impaired peripheral perfusion which may compromise the accuracy of a peripherally placed pulse oximeter. This decrease in peripheral perfusion may be especially apparent during exercise. The objective of this study was to determine if pulse oximeter accuracy is dependent on location in heart failure patients during peak exercise. ⋯ Forehead pulse oximeters may be more reliable compared to finger pulse oximeters in obtaining SpO2 measurements in HF patients during a treadmill maximal exercise test.
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Review Meta Analysis
Can haloperidol prophylaxis reduce the incidence of delirium in critically ill patients in intensive care units? A systematic review and meta-analysis.
The purpose of this study was to evaluate the efficacy and safety of haloperidol in the prevention of delirium in intensive care unit (ICU) patients. ⋯ The use of prophylactic haloperidol might reduce the incidence of delirium in postoperative patients admitted to an ICU, but not in all ICU patients.
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New onset Atrial Fibrillation (NOAF) is frequently seen post transcatheter aortic valve replacement (TAVR). NOAF in the setting of TAVR has also been recognized as predictor of worse outcomes, including higher readmission rates. Data assessing the effect and predictors of NOAF on 30-day readmission rates post TAVR is limited. ⋯ Incidence of NOAF is associated with increased risk of readmissions and ischemic stroke. Future research should focus on interventions to prevent avoidable readmissions and associated morbidity and mortality.
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Review Meta Analysis
Bicarbonate use and mortality outcome among critically ill patients with metabolic acidosis: A meta analysis.
The use of sodium bicarbonate in the treatment of metabolic acidosis in critically ill subjects has long been a subject of debate. Despite empiric use in the setting of severe acidemia in critically ill patients, there is little data looking into the role of sodium bicarbonate in the treatment of severe metabolic acidosis in the intensive care unit (ICU) setting. ⋯ There is no significant difference in mortality in the use of bicarbonate among critically ill patients with high anion gap metabolic acidosis predominantly driven by lactic acidosis.