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Critical Care

In Global News: Improving the Cardiac ICU, Individual Outcomes Reporting, 3D Technology, and Gene Therapy
July 21, 2017
Patient Care
Effect of Preoperative Inspiratory Muscle Training on Alveolar-Arterial Oxygen Gradients After Coronary Artery Bypass Surgery
July 12, 2017
Preoperative Inspiratory Muscle Training (IMT) with the Powerbreathe device was assessed with regard to whether A-a gradients and inspiratory muscle power would be improved after CABG.  A group of 40 male patients were randomized to receiving (20) or not receiving (20) preop IMT.
Methylene blue for postcardiopulmonary bypass vasoplegic syndrome: A cohort study
May 23, 2017
The authors conducted a retrospective cohort study of 88 patients that received methylene blue (MB) for refractory vasoplegia following cardiopulmonary bypass.  Administration of MB was associated with an 8 mmHg increase in mean arterial pressure, with the peak response occurring at 2 hours after completion of dose.  
Healthcare-Associated Infections in Cardiac Surgery Patients With Prolonged Intensive Care Unit Stay
April 17, 2017
Cardiac surgery patients with ICU stays of more than 7 days were evaluated for the incidence of healthcare-associated infections (HAI) over a 3-year period.  15% of over 2,500 pts had ICU stays of more than 7 days, of whom more than 48% had at least 1 HAI.  Mortality in those with HAI was more than twice as high as for those without (29% vs13%).
Temporary Mechanical Circulatory Support in Cardiac Critical Care: A State of the Art Review and Algorithm for Device Selection
January 31, 2017
The authors of this review article offer an approach to the utilization of a contempory mechanical circulatory support devices.  They further provide insights of the key role that well-functioning interdisciplinary teams contribute to the success of a MCS program and future directions to consider as this field continues to rapidly evolve.
Extracardiac Signs of Fluid Overload in the Critically Ill Cardiac Patient: A Focused Evaluation Using Bedside Ultrasound
January 31, 2017
Appropriate perioperative fluid management is of increasing interest for the team caring for  the critically ill cardiac patient as fluid overload has been shown to have negative effects on organ function.
Detection, Prevention, and Management of Delirium in the Critically Ill Cardiac Patient and Patients Who Undergo Cardiac Procedures
January 31, 2017
In this is review article the authors have proposed a "3-strike" model of risk that increases the likelihood of experiencing postoperative delirium in older adults undergoing cardiac surgery.
Complications After Cardiac Operations: All Are Not Created Equal
December 22, 2016
This single institution retrospective study analyzed the effects of single vs multiple complications on acute outcomes to help identify interactions among complications that might predict outcomes.  Over a 4 year period 366 pts experienced a complication and 102 of these had 2 or more complications.  Multiple complications were associated with mortal
Contemporary extracorporeal membrane oxygenation therapy in adults: Fundamental principles and systematic review of the evidence.
July 18, 2016
A handy mini-textbook on ECMO
Acute kidney injury following cardiac surgery: current understanding and future directions
July 5, 2016
Acute kidney injury (AKI) complicates recovery from cardiac surgery in up to 30% of patients, injures and impairs the function of the brain, lungs, and gut, and places patients at a 5-fold increased risk of death during hospitalization.

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