Heart, lung & circulation
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Heart, lung & circulation · Dec 2012
Case ReportsNeurocardiogenic pulmonary oedema: initial presentation of multiple sclerosis.
A previously healthy 20 year-old male presented with headache, acute pulmonary oedema and left ventricular dysfunction requiring intensive care admission. Cardiorespiratory symptoms resolved within three days; however, the patient complained of persistent headache and had gait unsteadiness. ⋯ The patient was subsequently diagnosed with multiple sclerosis. This case describes a rare initial presentation of multiple sclerosis with acute pulmonary oedema and cardiac dysfunction secondary to a lower brainstem lesion.
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Heart, lung & circulation · Nov 2012
Randomized Controlled TrialCan topical application of tranexamic acid reduce blood loss in thoracic surgery? A prospective randomised double blind investigation.
The systemic or topical use of antifibrinolytic agents is effective in reducing postoperative bleeding and blood product transfusion in cardiac surgery. We sought to study the effect of the topical application of tranexamic acid into the pleural space to reduce postoperative bleeding after lung surgery. ⋯ In our experience, the topical use of tranexamic-acid after lung surgery reduces postoperative bleeding and blood transfusion volume. The topical administration of tranexamic-acid is safe without increasing the risk of post-operative complications related to pharmacological side-effects.
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Heart, lung & circulation · Nov 2012
ReviewThe use of a PleurX catheter in the management of recurrent benign pleural effusion: a concise review.
Recurrent pleural effusion (RPE) can be encountered in various benign conditions such as inflammatory, infectious, or other systemic diseases (e.g., congestive heart failure (CHF), hepatic hydrothorax, post lung transplants, post coronary artery bypass graft (CABG) surgery, and chronic exudative pleurisy). Each condition is treated based on its unique pathophysiologic characteristics, and medical management is successful in the majority of patients. ⋯ We conducted a literature review using PubMed and Google Scholar, finding 33 articles that were relevant to our topic over the last 30 years. In patients with recurrent benign pleural effusion that is refractory to medical management, the PleurX catheter seems to be a useful tool in relieving respiratory symptoms, decreasing the rate of hospitalisation and achieving pleurodesis.
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Heart, lung & circulation · Nov 2012
Randomized Controlled TrialRisk model of prolonged intensive care unit stay in Chinese patients undergoing heart valve surgery.
The aim of this study was to develop a preoperative risk prediction model and an scorecard for prolonged intensive care unit length of stay (PrlICULOS) in adult patients undergoing heart valve surgery. ⋯ We developed and validated a local risk prediction model for PrlICULOS after adult heart valve surgery. This model can be used to calculate patient-specific risk with an equivalent predicted risk at our centre in future clinical practice.
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Heart, lung & circulation · Oct 2012
ReviewAcute rheumatic fever and rheumatic heart disease--priorities in prevention, diagnosis and management. A report of the CSANZ Indigenous Cardiovascular Health Conference, Alice Springs 2011.
Three priority areas in the prevention, diagnosis and management of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) were identified and discussed in detail: 1. Echocardiography and screening/diagnosis of RHD – Given the existing uncertainty it remains premature to advocate for or to incorporate echocardiographic screening for RHD into Australian clinical practice. Further research is currently being undertaken to evaluate the potential for echocardiography screening. 2. ⋯ Management of advanced RHD – National centres of excellence for the diagnosis, assessment and surgical management of RHD are required. Early referral for surgical input is necessary with multidisciplinary care and team-based decision making that includes patient, family, and local health providers. There is a need for a national RHD surgical register and research strategy for the assessment, intervention and long-term outcome of surgery and other interventions for RHD.