Subjects -> MEDICAL SCIENCES (Total: 8359 journals)
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RESPIRATORY DISEASES (102 journals)                     

Showing 1 - 102 of 102 Journals sorted alphabetically
Advances in Respiratory Medicine     Open Access   (Followers: 7)
American Journal of Respiratory and Critical Care Medicine     Full-text available via subscription   (Followers: 254)
American Journal of Respiratory Cell and Molecular Biology     Full-text available via subscription   (Followers: 20)
American Review of Respiratory Disease     Full-text available via subscription   (Followers: 4)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 16)
Annals of Thoracic Medicine     Open Access   (Followers: 6)
Archivos de Bronconeumología     Full-text available via subscription  
Archivos de Bronconeumología (English Edition)     Full-text available via subscription   (Followers: 1)
Asthma Research and Practice     Open Access   (Followers: 1)
BMC Pulmonary Medicine     Open Access   (Followers: 4)
BMJ Open Respiratory Research     Open Access   (Followers: 5)
Breathe     Open Access   (Followers: 4)
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal  
Canadian Respiratory Journal     Open Access   (Followers: 2)
Case Reports in Pulmonology     Open Access   (Followers: 3)
Chest     Full-text available via subscription   (Followers: 100)
Chest Disease Reports     Open Access   (Followers: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 9)
Clinical Lung Cancer     Hybrid Journal   (Followers: 5)
Clinical Medicine Insights : Circulatory, Respiratory and Pulmonary Medicine     Open Access   (Followers: 3)
Clinical Pulmonary Medicine     Hybrid Journal   (Followers: 2)
COPD Research and Practice     Open Access   (Followers: 1)
COPD: Journal of Chronic Obstructive Pulmonary Disease     Hybrid Journal   (Followers: 15)
Current Opinion in Pulmonary Medicine     Hybrid Journal   (Followers: 10)
Current Pulmonology Reports     Hybrid Journal  
Current Research in Tuberculosis     Open Access   (Followers: 3)
Current Respiratory Care Reports     Hybrid Journal   (Followers: 1)
Current Respiratory Medicine Reviews     Hybrid Journal   (Followers: 5)
Der Pneumologe     Hybrid Journal   (Followers: 1)
Egyptian Journal of Chest Diseases and Tuberculosis     Open Access   (Followers: 3)
ERJ Open Research     Open Access   (Followers: 2)
Eurasian Journal of Pulmonology     Open Access  
European Clinical Respiratory Journal     Open Access   (Followers: 3)
European Respiratory Journal     Full-text available via subscription   (Followers: 38)
European Respiratory Review     Open Access   (Followers: 7)
Experimental Lung Research     Hybrid Journal  
Expert Review of Respiratory Medicine     Hybrid Journal   (Followers: 5)
Heart & Lung: The Journal of Acute and Critical Care     Hybrid Journal   (Followers: 11)
Heart, Lung and Circulation     Full-text available via subscription   (Followers: 9)
Indian Journal of Respiratory Care     Open Access   (Followers: 3)
Indian Journal of Tuberculosis     Full-text available via subscription  
Influenza and Other Respiratory Viruses     Open Access   (Followers: 3)
International Journal of Chronic Obstructive Pulmonary Disease     Open Access   (Followers: 3)
Journal of Association of Chest Physicians     Open Access   (Followers: 2)
Journal of Asthma     Hybrid Journal   (Followers: 4)
Journal of Asthma Allergy Educators     Hybrid Journal   (Followers: 4)
Journal of Bronchology & Interventional Pulmonology     Hybrid Journal   (Followers: 3)
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases     Open Access  
Journal of Heart and Lung Transplantation     Hybrid Journal   (Followers: 12)
Journal of Respiratory Medicine     Open Access   (Followers: 4)
Journal of Respiratory Research     Open Access   (Followers: 1)
Journal of Tuberculosis Research     Open Access   (Followers: 1)
Jurnal Respirasi     Open Access  
Karger Kompass Pneumologie     Full-text available via subscription   (Followers: 1)
Kindheit und Entwicklung     Hybrid Journal  
Lung     Hybrid Journal   (Followers: 2)
Lung Cancer     Hybrid Journal   (Followers: 15)
Lung Cancer International     Open Access   (Followers: 2)
Lung Cancer: Targets and Therapy     Open Access   (Followers: 3)
Lung India     Open Access   (Followers: 1)
Multidisciplinary Respiratory Medicine     Open Access   (Followers: 4)
npj Primary Care Respiratory Medicine     Open Access   (Followers: 2)
Open Journal of Respiratory Diseases     Open Access   (Followers: 1)
Open Respiratory Medicine Journal     Open Access   (Followers: 1)
Paediatric Respiratory Reviews     Hybrid Journal   (Followers: 11)
Pediatric Quality & Safety     Open Access  
Pediatric Respirology and Critical Care Medicine     Open Access   (Followers: 1)
Pulmonary Circulation     Open Access   (Followers: 4)
Pulmonary Medicine     Open Access   (Followers: 2)
Pulmonary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 2)
Pulmonary Therapy     Open Access   (Followers: 1)
Pulmonology and Respiratory Research     Open Access   (Followers: 1)
Respiratory Care     Full-text available via subscription   (Followers: 10)
Respiratory Investigation     Full-text available via subscription  
Respiratory Medicine     Hybrid Journal   (Followers: 17)
Respiratory Medicine : X     Open Access  
Respiratory Medicine Case Reports     Open Access  
Respiratory Medicine CME     Hybrid Journal  
Respiratory Medicine Extra     Full-text available via subscription   (Followers: 1)
Respiratory Physiology & Neurobiology     Hybrid Journal   (Followers: 4)
Respiratory Research     Open Access   (Followers: 1)
Respirology     Hybrid Journal   (Followers: 5)
Respirology Case Reports     Open Access  
Revista Americana de Medicina Respiratoria     Open Access  
Revista Chilena de Enfermedades Respiratorias     Open Access  
Revista Inspirar     Open Access  
Revista ORL     Open Access  
Revista Portuguesa de Pneumologia     Open Access  
Sarcoidosis Vasculitis and Diffuse Lung Disese     Full-text available via subscription   (Followers: 3)
Seminars in Respiratory and Critical Care Medicine     Hybrid Journal   (Followers: 14)
Sleep Medicine Reviews     Hybrid Journal   (Followers: 17)
The Clinical Respiratory Journal     Hybrid Journal   (Followers: 3)
The International Journal of Tuberculosis and Lung Disease     Full-text available via subscription   (Followers: 8)
The Lancet Respiratory Medicine     Full-text available via subscription   (Followers: 32)
Therapeutic Advances in Chronic Disease     Open Access   (Followers: 7)
Therapeutic Advances in Respiratory Disease     Open Access   (Followers: 1)
Thorax     Hybrid Journal   (Followers: 37)
Translational Respiratory Medicine     Open Access   (Followers: 1)
Tuberculosis     Hybrid Journal   (Followers: 12)
Tuberculosis Research and Treatment     Open Access   (Followers: 3)
Пульмонология     Full-text available via subscription  


Similar Journals
Journal Cover
Heart & Lung: The Journal of Acute and Critical Care
Journal Prestige (SJR): 0.757
Citation Impact (citeScore): 2
Number of Followers: 11  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0147-9563 - ISSN (Online) 1527-3288
Published by Elsevier Homepage  [3161 journals]
  • Comparison between a nurse-led weaning protocol and a weaning protocol
           based on physician's clinical judgment in ICU patients
    • Abstract: Publication date: Available online 21 January 2020Source: Heart & LungAuthor(s): Atefeh Ghanbari, Aida Mohammad Ebrahimzadeh, Ezzat Paryad, Zahra Atrkar Roshan, Mohammad Kazem Mohammadi, Nasrin Mokhtari LakehAbstractPurposeThe purpose of this study was to compare a nurse-led weaning protocol with a physician-driven weaning protocol in mechanically ventilated (MV) patients.MethodsIn this quasi-experimental study with a one-group design, a total of 65 ICU patients, requiring MV for more than 72 h, were selected via convenience sampling. In routine practice, the physician's clinical judgment is needed to determine the patient's readiness for liberation from MV. A physician-driven weaning protocol was compared with a nurse-led protocol, using Burn's Weaning Scale (BWS) in three working phases. Descriptive and inferential statistics were measured for data analysis using SPSS version 16.ResultsBased on BWS, the mean MV duration was 111.75±33.46 h in the nurse-led weaning group and 125.12±43.43 h in the physician-driven weaning group. There was a significant difference in terms of MV duration between the two groups (P = 0.000).ConclusionThe present findings showed that nurses’ assessment of patient's readiness for weaning from MV (BWS) is a safe approach during the day, which can reduce MV duration more than other typical methods in ICUs.
  • Sex differences in factors associated with post-traumatic stress disorder
           in acute type A aortic dissection patients
    • Abstract: Publication date: Available online 14 January 2020Source: Heart & LungAuthor(s): Yiping Chen, Yanjuan Lin, Haoruo Zhang, Yanchun Peng, Sailan Li, Xizhen HuangAbstractBackgroundEmergency surgery for acute type A aortic dissection (AAAD) is associated with a high risk for posttraumatic stress disorder (PTSD), and the risk factors for PTSD symptoms development in AAAD patients of different sexes remain unclear.ObjectiveTo identify the risk factors for PTSD symptoms separately in the females and males following AAAD.MethodsA sample population of 214 patients who had AAAD surgery was recruited. Patients’ sociodemographic and disease-specific data were collected during hospitalization.ResultsIn this study, PTSD symptoms was present in 22.1% of the male patients and 20.0% of the female patients (P = 0.739). For the male patients with AAAD, PTSD symptoms were significantly positively associated with HADS-D score (P = 0.029), while those with university education and above (P = 0.039), stronger subjective support (P = 0.010) and greater optimism (P = 0.001) had significantly lower possibility for the presence of PTSD symptoms. For the female patients with AAAD, support availability (P = 0.031) was significantly negatively associated with PTSD symptoms while HADS-D score (P = 0.033) was significantly positively associated with PTSD symptoms.ConclusionRisk factors for PTSD symptoms differ in male patients and female patients following AAAD.
  • Falls in community-dwelling older adults with heart failure: A
           retrospective cohort study
    • Abstract: Publication date: Available online 10 January 2020Source: Heart & LungAuthor(s): Kayoung Lee, Matthew A. Davis, John E. Marcotte, Susan J. Pressler, Jersey Liang, Nancy A. Gallagher, Marita G. TitlerAbstractBackgroundWhile heart failure (HF) in older adults is associated with fall risk, little is known about this in the U.S.ObjectiveTo examine the independent effect of functional impairments related to HF on falls among community-dwelling older adults in the U.S.MethodsA retrospective cohort study was conducted with 17,712 community-dwelling older adults aged 65 and above with (n = 1693) and without HF, using mixed-effects logistic regression to examine the association between HF and falls.ResultsHF patients had 14% greater odds of falling than those without HF. Moreover, HF patients with functional difficulties in mobility, large muscle difficulty, instrumental activities of daily living difficulty, poor vision, and urinary incontinence demonstrated an increased likelihood of falling.ConclusionCommunity-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.
  • German Network for Early Mobilization: Impact for participants
    • Abstract: Publication date: Available online 7 January 2020Source: Heart & LungAuthor(s): Peter Nydahl, Eva Spindelmann, Carsten Hermes, Arnold Kaltwasser, Stefan J. SchallerAbstractProfessional networks support health care providers in implementing evidence based knowledge. The German Network for Early Mobilization in Intensive Care Units (ICU) was founded in 2011 and serves for more than 300 critical care team members today. The mobilization network is connected to other professional networks and contributed to the development of national guidelines and quality indicators. Several research projects were conducted. Members of the mobilization network perceived benefits for themselves and their workplace. The network increased participants’ knowledge and contributed to quality improvement projects on ICUs. Without having significant resources, this network development may serve as an example for other networks.
  • Predictors, burden and impact of cardiac arrhythmias among patients
           hospitalized with end-stage liver disease
    • Abstract: Publication date: January–February 2020Source: Heart & Lung, Volume 49, Issue 1Author(s): Adeyinka Charles Adejumo, Kelechi Lauretta Adejumo, Olalekan Akanbi, Oluwole Muyiwa Adegbala, Quazim Adegbola Alayo, Daniel Obadare Fijabi, Olumuyiwa Akinbolaji Ogundipe, Nureddin Almaddah, Lydie Pani, Adedayo AdeboyeAbstractBackgroundCirrhotic cardiomyopathy, hyperammonemia, and hepatorenal syndrome predispose to cardiac arrhythmias in End-stage liver disease (ESLD).ObjectivesAmong ESLD hospitalizations, we evaluate the distribution and predictors of arrhythmias and their impact on hospitalization outcomes.MethodsWe selected ESLD records from the Nationwide Inpatient Sample (2007–2014), identified concomitant arrhythmias (tachyarrhythmias and bradyarrhythmias), and their demographic and comorbid characteristics, and estimated the effect of arrhythmia on outcomes (SAS 9.4).ResultsOf 57,119 ESLD hospitalizations, 6,615 had arrhythmias with higher odds with increasing age, males, jaundice, hepatorenal syndrome, alcohol use, and cardiopulmonary disorders. The most common arrhythmias were atrial fibrillation, cardiac arrest/asystole, and ventricular tachycardia. After propensity-matching (arrhythmia: no-arrhythmia, 6,609:6,609), arrhythmias were associated with 200% higher mortality, 1.7-days longer stay, $32,880 higher cost, and higher rates of shock, respiratory and kidney failures.ConclusionsDue to worse outcomes with arrhythmias, there is a need for better screening and follow-up of ESLD patients for dysrhythmias.
  • From labor and delivery to left ventricular assist device: A peripartum
           cardiomyopathy case report
    • Abstract: Publication date: January–February 2020Source: Heart & Lung, Volume 49, Issue 1Author(s): Rachel HayworthAbstractObjectiveTo report a peripartum cardiomyopathy (PPCM) case resulting in the implantation of a permanent left ventricular assist device (LVAD) as destination therapy.MethodElectronic medical record and literature review surrounding PPCM.ResultsA 39-year-old African America female of 38 weeks gestation presented to labor and delivery triage complaining of lower extremity edema and shortness of breath. Evaluation yielded an ejection fraction of 20–25% with left ventricular dilation, cardiomegaly, and interstitial edema. Following delivery, the patient experienced respiratory distress and was transferred to the cardiac intensive care unit (CICU) where she was stabilized and discharged. Within four weeks, the patient experienced sudden cardiac arrest requiring intubation, induced hypothermic treatment, and intravenous vasopressor and inotrope support. The patient was transferred out of CICU and discharged home with close outpatient follow-up in the heart failure clinic before urgently receiving a LVAD.ConclusionPPCM is a life-threatening and life-changing condition requiring highly specialized interdisciplinary care.
  • Self-care confidence mediates self-care maintenance and management in
           patients with heart failure
    • Abstract: Publication date: January–February 2020Source: Heart & Lung, Volume 49, Issue 1Author(s): Angela Massouh, Hadi Skouri, Paul Cook, Huda Abu Saad Huijer, Maurice Khoury, Paula MeekAbstractBackgroundLiterature highlights the influence of self-care confidence on self-care in patients with heart failure (HF), but little is known whether it explains the influence of other determinants of self-care.ObjectivesTo examine whether confidence explained the associations of social support and HF-knowledge with self-care.MethodsIn a descriptive, correlational study, 100 patients with HF completed questionnaires on self-care, social support, and HF-specific knowledge. Regression analyses were used to examine associations between perceived support and HF-knowledge and self-care.ResultsSelf-care confidence mediated the association between social support and self-care maintenance (path reduced from Beta = 0.713 to 0.395) and HF-knowledge and maintenance (path reduced from Beta = 2.569 to 1.798) and management (path reduced from Beta = −0.272 to −0.144).ConclusionSelf-care confidence explains the influence of social support and knowledge on self-care. Supporting self-care confidence may be a key target for interventions to improve disease management and behaviors in patients with HF.
  • Information for Authors
    • Abstract: Publication date: January–February 2020Source: Heart & Lung, Volume 49, Issue 1Author(s):
  • Information for Readers
    • Abstract: Publication date: January–February 2020Source: Heart & Lung, Volume 49, Issue 1Author(s):
  • Board of Directors
    • Abstract: Publication date: January–February 2020Source: Heart & Lung, Volume 49, Issue 1Author(s):
  • Prognostic impact of high sensitive Troponin T in patients with influenza
           virus infection: A retrospective analysis
    • Abstract: Publication date: January–February 2020Source: Heart & Lung, Volume 49, Issue 1Author(s): Alex Pizzini, Francesco Burkert, Igor Theurl, Günter Weiss, Rosa Bellmann-WeilerAbstractBackgroundSeasonal influenza is an important cause of morbidity and mortality worldwide and cardiac injuries are dangerous complications of influenza infection. Cardiac troponins are established biomarkers of myocardial damage.ObjectiveThe aim of the study was to assess high sensitive Troponin-T (hsTnT) serum levels as a surrogate parameter of cardiac involvement in influenza patients.MethodsCross-sectional analysis of 264 patients with laboratory-confirmed influenza virus infection. Routine laboratory parameters, hsTNT, and the history of cardiovascular disease were included in the analysis. Assessed prognostic endpoints were inpatient therapy requirement, death 
  • Dose dependency of amiodarone induced “Blue man syndrome”
    • Abstract: Publication date: Available online 24 December 2019Source: Heart & LungAuthor(s): Özge Turgay Yildirim, Ayşegül Turgay
  • Hospital outcomes in non-surgical patients identified at risk for OSA
    • Abstract: Publication date: Available online 24 December 2019Source: Heart & LungAuthor(s): Sikandar H Khan, Shalini Manchanda, Ninotchka L Sigua, Erika Green, Philani B Mpofu, Siu Hui, Babar A. KhanAbstractBackgroundIn-hospital respiratory outcomes of non-surgical patients with undiagnosed obstructive sleep apnea (OSA), particularly those with significant comorbidities are not well defined. Undiagnosed and untreated OSA may be associated with increased cardiopulmonary morbidity.Study objectivesEvaluate respiratory failure outcomes in patients identified as at-risk for OSA by the Berlin Questionnaire (BQ).MethodsThis was a retrospective study conducted using electronic health records at a large health system. The BQ was administered at admission to screen for OSA to medical-service patients under the age of 80 years old meeting the following health system criteria: (1) BMI greater than 30; (2) any of the following comorbid diagnoses: hypertension, heart failure, acute coronary syndrome, pulmonary hypertension, arrhythmia, cerebrovascular event/stroke, or diabetes. Patients with known OSA or undergoing surgery were excluded. Patients were classified as high-risk or low-risk for OSA based on the BQ score as follows: low-risk (0 or 1 category with a positive score on the BQ); high-risk (2 or more categories with a positive score on BQ). The primary outcome was respiratory failure during index hospital stay defined by any of the following: orders for conventional ventilation or intubation; at least two instances of oxygen saturation less than 88% by pulse oximetry; at least two instances of respiratory rate over 30 breaths per minute; and any orders placed for non-invasive mechanical ventilation without a previous diagnosis of sleep apnea. Propensity scores were used to control for patient characteristics.ResultsRecords of 15,253 patients were assessed. There were no significant differences in the composite outcome of respiratory failure by risk of OSA (high risk: 11%, low risk: 10%, p = 0.55). When respiratory failure was defined as need for ventilation, more patients in the low-risk group experienced invasive mechanical ventilation (high-risk: 1.8% vs. low-risk: 2.3%, p = 0.041). Mortality was decreased in patients at high-risk for OSA (0.86%) vs. low risk for OSA (1.53%, p 
  • Stroke impact symptoms are associated with sleep-related impairment
    • Abstract: Publication date: Available online 12 December 2019Source: Heart & LungAuthor(s): Eeeseung Byun, Ruth Kohen, Kyra J. Becker, Catherine J. Kirkness, Sandeep Khot, Pamela H. MitchellAbstractBackgroundSleep-related impairment is a common but under-appreciated complication after stroke and may impede stroke recovery. Yet little is known about factors associated with sleep-related impairment after stroke.ObjectiveThe purpose of this analysis was to examine the relationship between stroke impact symptoms and sleep-related impairment among stroke survivors.MethodsWe conducted a cross-sectional secondary analysis of a baseline (entry) data in a completed clinical trial with 100 community-dwelling stroke survivors recruited within 4 months after stroke. Sleep-related impairment and stroke impact domain symptoms after stroke were assessed with the Patient-Reported Outcomes Measurement Information System Sleep-Related Impairment scale and the Stroke Impact Scale, respectively. A multivariate regression was computed.ResultsStroke impact domain—mood (B = −0.105, t = −3.263, p = .002) — and fatigue (B = 0.346, t = 3.997, p 
  • Electronic cigarette use among heart failure patients: Findings from the
           Population Assessment of Tobacco and Health study (Wave 1: 2013–2014)
    • Abstract: Publication date: Available online 5 December 2019Source: Heart & LungAuthor(s): Emily C. Gathright, Wen-Chih Wu, Lori A.J. Scott-SheldonAbstractBackgroundSmoking cessation is recommended for adults with heart failure (HF). The prevalence of e-cigarette use among adults with HF is unknown.ObjectiveTo determine prevalence of and reasons for e-cigarette use among adults with HF.MethodsData from the Population Assessment of Tobacco and Health Study (Wave 1) were examined.ResultsOf 484 respondents with HF, 1% (weighted) reported current e-cigarette use, and 5% (weighted) reported dual cigarette/e-cigarette use. Adults with HF had higher odds of dual use (OR = 1.76, 95% CI: 1.22–2.54) compared to those without HF, controlling for age, sex, race, and income. Dual users with HF reported using e-cigarettes because they may be less harmful to nearby people and to themselves than cigarettes.ConclusionsE-cigarette use should be assessed and monitored to understand the safety and potential efficacy of e-cigarettes as a harm reduction approach for HF patients.
  • Thyrotoxicosis-induced cardiomyopathy treated with venoarterial
           extracorporeal membrane oxygenation
    • Abstract: Publication date: Available online 5 July 2019Source: Heart & LungAuthor(s): Ivo Genev, Michelle D. Lundholm, Mary Ann Emanuele, Edwin McGee, Verghese MathewAbstractA 37-year-old woman with no past medical history presented with longstanding untreated hyperthyroidism and consequentially developed thyrotoxicosis-induced cardiomyopathy. Upon admission, she was noted with a heart rate of 172 beats per minute and an EKG consistent with supraventricular tachycardia which was unresponsive to adenosine. Shortly after the initiation of a non-cardioselective beta-blocker for the treatment of persistent tachycardia, she developed profound cardiogenic shock refractory to vasopressors and inotropes. She was diagnosed with thyroid storm, which was ultimately attributed to Graves' Disease and controlled with propylthiouracil, potassium iodide drops, and hydrocortisone. Extracorporeal membrane oxygenation (ECMO) was successfully used as a temporizing measure while her thyroid hormone level normalized and cardiac function recovered. Patients with longstanding untreated hyperthyroidism may be dependent on the induced hyperadrenergic state to compensate for low-output cardiac failure, therefore it is important to exercise caution when initiating beta-adrenergic blockade. Given the expected disease time-course in cases of acute decompensation, ECMO remains a viable option for short-term mechanical circulatory support.
  • Complete atrioventricular block caused by pulmonary embolism: A case
           report and review of literature
    • Abstract: Publication date: Available online 24 June 2019Source: Heart & LungAuthor(s): Peter C. Olson, Michael Cinelli, Edmond Kurtovic, Emad Barsoum, Jonathan Spagnola, James LaffertyAbstractIntroductionAcute electrocardiogram abnormalities are common in patients afflicted with pulmonary embolism (PE). Rarely, a patient with acute pulmonary embolism and electrocardiogram changes may have an underlying conduction abnormality that complicates their course.Case presentationWe describe a patient with known history of left bundle branch block who presented with acute PE and developed a right bundle branch block, which devolved into complete third degree heart block without ventricular escape rhythm and led to concomitant hemodynamic compromise.DiscussionGiven the rarity of this clinical scenario, we call for clinicians to be aware of PE-associated conduction pathology as well as the possibility that malignant cardiac conduction blocks may occur in the setting of PE particularly if the patient is known to have underlying conduction system disease. We emphasize the importance of continuous telemetry monitoring in patients presenting with PE as these types of arrhythmic complications and hemodynamic decompensation has been observed.
  • Amiodarone induced “Blue man syndrome”; an unusual
    • Abstract: Publication date: Available online 25 November 2019Source: Heart & LungAuthor(s): Troy J. Fishman, Sanjae Spencer, Robert Harrell, Joshua K. SalabeiAbstractAmiodarone is a common antiarrhythmic medication used in daily practice with excellent efficiency. While it has many benefits, there are several common adverse reactions, such as abnormal thyroid function and cornea verticillata, associated with its use. A much less common adverse reaction is the so-called “Blue man syndrome,” occurring in 1–3% of patients. Blue man syndrome is thought to stem from the deposition of lysosomal membrane-bound dense bodies, similar to lipofuscin, in the dermis of patients on chronic amiodarone therapy. We present the case of a 77-year-old male who presented to us post-cardiac arrest secondary to hyperkalemia of 7.0. Although it was noted in the patient's chart that he had an “allergy” to amiodarone (it was noted in his chart it only turned his leg black), it was used in the emergency department because of the failure of other antiarrhythmics to treat his arrhythmia and all other medical options were exhausted. It was decided that the benefits of using amiodarone far outweighed the risks of it. Ultimately it was found that the patient did not have a true allergy to amiodarone, but suffered from a known benign adverse effect of the drug resulting in a greyish-blue tinge to his bilateral lower extremities. His-presentation differs from the normal presentation of blue man syndrome which appears more commonly on sun-exposed areas of the body such as the face and arms. While this is a benign adverse effect of amiodarone, it can be very distressing to patients and must be addressed.
  • Cross-classification of physical and affective symptom clusters and
           180-day event-free survival in moderate to advanced heart failure
    • Abstract: Publication date: Available online 18 November 2019Source: Heart & LungAuthor(s): Quin E. Denfeld, Julie T. Bidwell, Jill M. Gelow, James O. Mudd, Christopher V. Chien, Shirin O. Hiatt, Christopher S. LeeAbstractBackgroundThe relationship between physical and affective symptom clusters in heart failure (HF) is unclear.ObjectivesTo identify associations between physical and affective symptom clusters in HF and to quantify outcomes and determinants of symptom subgroups.MethodsThis was a secondary analysis of data from two cohort studies among adults with HF. Physical and affective symptom clusters were compared using cross-classification modeling. Cox proportional hazards modeling and multinomial logistic regression were used to identify outcomes and determinants of symptom subgroups, respectively.ResultsIn this young, mostly male sample (n = 274), physical and affective symptom clusters were cross-classified in a model with acceptable fit. Three symptom subgroups were identified: congruent-mild (69.3%), incongruent (13.9%), and congruent-severe (16.8%). Compared to the congruent-mild symptom group, the incongruent symptom group had significantly worse 180-day event-free survival.ConclusionCongruence between physical and affective symptom clusters should be considered when identifying patients at higher risk for poor outcomes.
  • Adherence to diet and medication and the associated factors among patient
           with chronic heart failure in a multi-ethnic society
    • Abstract: Publication date: Available online 16 November 2019Source: Heart & LungAuthor(s): Rachel Zi Qian Ling, Nana Jiao, Norasyikin Bte Hassan, Honggu He, Wenru WangAbstractObjectiveTo investigate diet adherence, medication adherence and self-care behaviour among patients with chronic heart failure (CHF) in a multi-ethnic society and identify the significant factors associated with their diet and medication adherence.MethodsA cross-sectional descriptive correlational study was conducted with a convenience sample of 107 patients with CHF recruited from two cardiology wards of a public tertiary hospital in Singapore. Study variables were measured using the Dietary Sodium Restriction Questionnaire, the Medication Adherence Rating Scale-5 items and the European Heart Failure Self-care Behaviour Scale-12 items.ResultsOur sample reported positive attitudes towards diet adherence, poor self-care behaviour, and good medication adherence. The multiple linear regression results indicated that lower income, Chinese ethnicity, diabetic complications, current smoking, lower New York Heart Association classification I and II, and poorer self-care behaviour predicted poorer diet adherence. In addition, absence of hypertension, having non-myocardial infarction as a cause of CHF, and moderately diminished ejection fraction were identified as significant predictors of poorer medication adherence.ConclusionThe findings from this study have established the need to improve current education and rehabilitation programmes for patients with CHF by addressing those factors significantly influencing their adherence to diet and medication.
  • An observational study of the management practices and outcomes of
           patients with new onset atrial fibrillation in non-cardiothoracic
    • Abstract: Publication date: Available online 15 November 2019Source: Heart & LungAuthor(s): Mihaela Tiru, Anis John Kadado, Vida Rastegar, Kanval Shah, Kirti K Joshi, Peter Lindenauer, Tara Lagu, Mihaela S StefanAbstractBackground and objectiveLimited data exist on characteristics and management of patients with postoperative atrial fibrillation (POAF) after noncardiothoracic surgeries and on the relationship between symptoms and outcomes. We sought to describe clinical features, in-hospital practices and outcomes in patients with new POAF by the presence or absence of clinical symptoms.MethodsRetrospective cohort study of adults with POAF in one tertiary center.ResultsAmong the 99 patients who fulfilled the eligibility criteria, median age was 75 years (IQR 64–83) and 57.6% were male. Only thirty percent of patients with POAF were symptomatic. Rate control/conversion to sinus rhythm was achieved in ≤ 4 h in 56% of the patients and in 80% was maintained for ≥ 24 h. Anticoagulation was prescribed in 50% of those discharged in AF; the CHADS2-VASc score was not associated with anticoagulation prescribed. One third of patients were readmitted and half of them were in AF. Asymptomatic patients had lower median heart rate than symptomatic patients but no other clinical characteristics, or outcomes were different.ConclusionsMost patients with POAF were asymptomatic but their presentation or outcomes were similar with symptomatic patients. One in four discharged patients was prescribed anticoagulation and the CHADS2-VASC score was not associated with this decision. These findings have important implications for practice and future research. There is a need to better delineate the risk associated with transient versus persistent POAF, symptomatic versus asymptomatic POAF, as well as for clinical trials to determine optimal strategies to improve their outcomes.
  • Comment on: “From labor and delivery to left ventricular assist device:
           A peripartum cardiomyopathy case report”
    • Abstract: Publication date: Available online 15 November 2019Source: Heart & LungAuthor(s): Özge Turgay Yıldırım, Özge Senem YÜCEL ÇİÇEK
  • Reaction time and functional balance in chronic obstructive pulmonary
    • Abstract: Publication date: Available online 15 November 2019Source: Heart & LungAuthor(s): Serdar Kalemci, Aydın Sarıhan, Abdullah Şimşek, Arife Zeybek
  • Aorto-cardiac fistula etiology, presentation, and management: A systematic
    • Abstract: Publication date: Available online 15 November 2019Source: Heart & LungAuthor(s): Tianne J. Foster, Ali Hama Amin, Tatiana Busu, Kinjan Patel, Peter Farjo, Abdulrahman Al Hallak, Nyaz Ali, Mohamad AlkhouliAbstractBackgroundAorto-cardiac fistulae are a rare but increasingly reported entity, and data are scarce.MethodThe authors performed a systematic review of ACFs to characterize the underlying etiology, clinical presentation, and compare outcomes of treatment strategies.Results3,733 publications were identified in the search. Of those, 292 studies including 300 patients were included. Etiology of ACFs was 38% iatrogenic, 25% infectious, 14% traumatic, and 15% due to other causes. Most patients (74%) presented with heart failure. Common locations were aortic-right atrium (37%), and aortic-pulmonary artery (25%). The majority of patients (71%) were treated surgically, while 13% were treated percutaneously, and 16% were treated conservatively. Patients who were managed conservatively had a higher mortality than those treated with invasive closure (53% vs. 12% vs. 3%, p =
  • A comparison of finger and forehead pulse oximeters in heart failure
           patients during maximal exercise
    • Abstract: Publication date: Available online 14 November 2019Source: Heart & LungAuthor(s): Kevin L. Kelly, Alex R. Carlson, Thomas G. Allison, Bruce D. JohnsonAbstractBackgroundPulse 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.Methods20 participants with HF (7F, age 64.±11 yr) and 9 participants with coronary artery disease as controls (CAD: 3F, age 66±5 yr) performed a maximal exertion treadmill exercise stress test while wearing both finger and forehead pulse oximeters.ResultsAt peak exercise, the two pulse oximeters measurements of SpO2 differed from each other by 3.8 ± 3.3% in the HF group (p
  • Airway and transpulmonary driving pressures and mechanical powers selected
           by INTELLiVENT-ASV in passive, mechanically ventilated ICU patients
    • Abstract: Publication date: Available online 14 November 2019Source: Heart & LungAuthor(s): Jean-Michel Arnal, Mathieu Saoli, Aude GarneroAbstractBackgroundDriving pressure (ΔP) and mechanical power (MP) are predictors of the risk of ventilation- induced lung injuries (VILI) in mechanically ventilated patients. INTELLiVENT-ASV® is a closed-loop ventilation mode that automatically adjusts respiratory rate and tidal volume, according to the patient's respiratory mechanics.ObjectivesThis prospective observational study investigated ΔP and MP (and also transpulmonary ΔP (ΔPL) and MP (MPL) for a subgroup of patients) delivered by INTELLiVENT-ASV.MethodsAdult patients admitted to the ICU were included if they were sedated and met the criteria for a single lung condition (normal lungs, COPD, or ARDS). INTELLiVENT-ASV was used with default target settings. If PEEP was above 16 cmH2O, the recruitment strategy used transpulmonary pressure as a reference, and ΔPL and MPL were computed. Measurements were made once for each patient.ResultsOf the 255 patients included, 98 patients were classified as normal-lungs, 28 as COPD, and 129 as ARDS patients. The median ΔP was 8 (7 − 10), 10 (8 − 12), and 9 (8 − 11) cmH2O for normal-lungs, COPD, and ARDS patients, respectively. The median MP was 9.1 (4.9 – 13.5), 11.8 (8.6 – 16.5), and 8.8 (5.6 – 13.8) J/min for normal-lungs, COPD, and ARDS patients, respectively. For the 19 patients managed with transpulmonary pressure ΔPL was 6 (4 − 7) cmH2O and MPL was 3.6 (3.1 – 4.4) J/min.ConclusionsIn this short term observation study, INTELLiVENT-ASV selected ΔP and MP considered in safe ranges for lung protection. In a subgroup of ARDS patients, the combination of a recruitment strategy and INTELLiVENT-ASV resulted in an apparently safe ΔPL and MPL.
  • Bicarbonate use and mortality outcome among critically ill patients with
           metabolic acidosis: A meta analysis
    • Abstract: Publication date: Available online 14 November 2019Source: Heart & LungAuthor(s): Kevin Bryan Lo, Veronica Garvia, Jessica M. Stempel, Pradhum Ram, Janani RangaswamiAbstractBackgroundThe 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.MethodsWe conducted a comprehensive search of Pubmed and Cochrane Central Register of Controlled Trials addressing bicarbonate use in the metabolic acidosis in the intensive care unit (ICU) setting. We examined mortality as end point. Pooled odds ratios (OR) and their 95% confidence intervals (CI) were calculated for all outcomes using a random-effect model.ResultsThe final search yielded 202 articles of which all were screened individually. A total of 11 studies were identified but 6 studies were excluded due to irrelevance in mortality outcome and methodology. Analysis was done separately for observational studies and randomized controlled trials. The pooled OR [95% CI] for mortality with bicarbonate use in the observational studies was 1.5 [0.62–3.67] with heterogeneity of 67%, while pooled OR for mortality in the randomized trials was 0.72 [0.49–1.05] (figure 2). In combining all studies, the pooled odds ratio was 0.93 95% [0.69–1.25] but with heterogeneity of 63%. After sensitivity analysis with removing the study done by Kim et al. 2013, heterogeneity was 0% with OR 0.8 [0.59–1.10].ConclusionThere 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.
  • Board of Directors
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s):
  • Long-term health-related quality of life of adult patients treated with
           extracorporeal membrane oxygenation (ECMO): An integrative review
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Krista A. Knudson, Carolina M. Gustafson, Lois S. Sadler, Robin Whittemore, Nancy S. Redeker, Laura K. Andrews, Abeel Mangi, Marjorie FunkAbstractBackground: Extracorporeal membrane oxygenation (ECMO), a rescue treatment for patients with severe pulmonary and/or cardiac dysfunction, is increasingly being used worldwide. A better understanding of long-term health-related quality of life (HRQOL) is needed. Objective: To synthesize research on long-term (at least 6 months post-ECMO) HRQOL of adults treated with ECMO. Methods: In this integrative review, we searched 3 electronic databases and did a hand search of relevant journals for articles published 2000–2019, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Thirty-one studies, representing 913 patients treated with ECMO, were included. Long-term HRQOL was slightly better for patients treated with veno-venous ECMO than veno-arterial ECMO, and mental health outcomes tended to be better than physical ones. Survivors frequently experienced physical complications, functional limitations, anxiety, depression, and post-traumatic stress symptoms, although improvements were observed over time. Conclusions: Early identification and management of physical and mental health problems may improve HRQOL outcomes.
  • Use of handgrip dynamometry for diagnosis and prognosis assessment of
           intensive care unit acquired weakness: A prospective study
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Renan Detoffol Bragança, Cecilia Gómez Ravetti, Lídia Barreto, Thiago Bragança Lana Silveira Ataíde, Rafael Mourão Carneiro, Antônio Lúcio Teixeira, Vandack NobreAbstractObjectivesTo test the agreement between handgrip dynamometry and Medical Research Council (MRC) criteria for the diagnosis of intensive care unit acquired weakness (ICUAW) and to evaluate if dynamometry findings are associated with morbidity and mortality.MethodsA prospective single center cohort study was conducted in a Brazilian ICU. Adults requiring at least 5 days of critical care were included. Primary outcome was the agreement between ICUAW diagnosis as assessed by the MRC score and the handgrip strength dynamometry. Exploratory outcomes were in-ICU, in-hospital, 6-month and one-year mortality, days of mechanical ventilation, length of ICU and hospital stay (in the present hospitalization and during the 6-month follow-up) and ICU readmission in six months.ResultsWe included 45 consecutive subjects, of which 18 of them had ICUAW according to MRC criteria. Using sex specific thresholds, handgrip strength had high agreement with MRC criteria for ICUAW diagnosis (100% accuracy; Kappa coefficient = 1; p
  • Comparison of early and midterm outcomes after transsubclavian/axillary
           versus transfemoral, transapical, or transaortic transcatheter aortic
           valve implantation
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Hisato Takagi, Yosuke Hari, Kouki Nakashima, Toshiki Kuno, Tomo Ando, ALICE (All-Literature Investigation of Cardiovascular Evidence) GroupAbstractBackgroundOutcomes after transsubclavian/transaxillary (TSc/TAx)-transcatheter aortic valve implantation (TAVI) have been unclear.ObjectivesTo compare outcomes after TSc/TAx-TAVI versus transfemoral (TF)-TAVI, transapical (TAp)-TAVI, or transaortic (TAo)-TAVI, we performed meta-analysis of currently available studies.MethodsStudies considered for inclusion met the following criteria: the study population was patients undergoing TAVI; patients were assigned to TSc/TAx-TAVI and TF-TAVI, TAp-TAVI, or TAo-TAVI; and at least one of postprocedural early (30-day or in-hospital) or late (including early) outcomes was reported. An odds or hazard ratio of each early or late outcome with its 95% confidence interval for TSc/TAx-TAVI versus the other approach was extracted from each individual study and combined in the random-effects model.ResultsOur search identified 15 eligible reports from 12 studies including 10,528 patients. Pooled analysis of early all-cause mortality demonstrated a statistically significant reduction after TSc/TAx-TAVI compared with TAp-TAVI (P = 0.003) or TAo-TAVI (P = 0.03). Pooled analysis of early pacemaker implantation demonstrated a statistically significant increase after TSc/TAx-TAVI compared with TAp-TAVI (P = 0.0001) or TAo-TAVI (P < 0.00001). Pooled analysis of midterm all-cause mortality demonstrated a statistically significant increase after TSc/TAx-TAVI compared with TF-TAVI (P = 0.007).ConclusionsEarly all-cause mortality was lower after TSc/TAx-TAVI than TAp-TAVI or TAo-TAVI, early pacemaker implantation was more frequent after TSc/TAx-TAVI than TAp-TAVI or TAo-TAVI, and midterm all-cause mortality was higher after TSc/TAx-TAVI than TF-TAVI.
  • The association of preoperative atrial fibrillation with
           post-cardiopulmonary bypass hyperfibrinolysis in rheumatic valvular heart
           disease patients
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Zheng Guan, Yong-Jian Zhang, Lin Liu, Xin Shen, Yan-Feng Gao, Xiao-Gang Li, Rong-Sheng Zhou, Jing-Jie LiuAbstractObjectiveThe purpose of this study was to assess the fibrinolytic status after cardiopulmonary bypass in rheumatic valvular heart disease patients, and detect the associated factors of post-cardiopulmonary bypass hyperfibrinolysis.MethodsAccording to the fibrinolytic status after cardiopulmonary bypass, 203 rheumatic valvular heart disease patients were divided into two groups: hyperfibrinolysis group (H group, n = 78) and non-hyperfibrinolysis group (NH group, n = 125). The demographic characteristics, operative variables, and postoperative follow-ups were compared between these two groups.ResultsThe incidence of hyperfibrinolysis was 38.4% after cardiopulmonary bypass. Patients in the H group had a significant higher incidence of preoperative atrial fibrillation than patients in the NH group (92.3% vs. 55.2%, P 
  • A multi-component, family-focused and literacy-sensitive intervention to
           improve medication adherence in patients with heart failure–A randomized
           controlled trial
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Jia-Rong Wu, Barbara Mark, George J. Knafl, Sandra B. Dunbar, Patricia P. Chang, Darren A. DeWaltAbstractBackgroundMedication nonadherence is prevalent and links to serious outcomes (e.g., rehospitalization/death) in heart failure (HF) patients; therefore, an urgent need exists for an intervention to improve and sustain adherence after intervention completion.ObjectivesTo test the efficacy of a multi-component, family-focused, literacy-sensitive (FamLit) intervention on medication adherence in HF patients.MethodsForty-three HF patients and their care partners were enrolled and randomized to receive FamLit or attention-only intervention, including an in-person session at baseline and bi-weekly phone boosters for 3 months. We measured medication adherence from baseline to 3-month post-intervention using the Medication Event Monitoring System.ResultsAfter 3-month intervention, intervention patients had significantly better medication adherence than control patients. At 6 months (3-months post-intervention), intervention effect on adherence was sustained in the FamLit intervention group, while adherence decreased in the control group.ConclusionIncorporating care partner support and providing an easy-to-understand intervention to patients-care partners may improve/sustain adherence.
  • Self-care in Chinese heart failure patients: Gender-specific correlates
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Xi Cao, Sek Ying Chair, Xiuhua Wang, Han Shi Jocelyn Chew, Ho Yu ChengAbstractBackgroundExisting studies have indicated that poor self-care in heart failure (HF) patients may differ according to gender but such studies remain scarce among Chinese HF patients.ObjectiveTo explore gender difference in correlates of self-care in Chinese HF patients.MethodA cross-sectional study on Chinese HF patients (n = 127) from cardiac wards of two hospitals in China was conducted. Data on participants’ socio-demographic and clinical characteristics, self-care, HF knowledge, social support, and self-care confidence were collected. Correlates of HF self-care were explored using hierarchical multiple regression.ResultsGender differences were observed in Chinese HF patients, who generally performed poorly in self-care. In males, self-care maintenance was associated with HF knowledge while self-care management was associated with social support. In females, maintenance was associated with self-care confidence while management was associated with both self-care confidence and HF knowledge.ConclusionCorrelates of self-care differed between two genders in Chinese HF patients. These gender-specific factors should be considered when planning self-care intervention or educating HF patients.
  • Understanding communal coping among patients and informal caregivers with
           heart failure: A mixed methods secondary analysis of patient-caregiver
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Jennalee S. Wooldridge, Caroline Gray, Ambri Pukhraj, Jessica Geller, Ranak B. TrivediAbstractBackgroundDyads that view illnesses as shared stressors (“shared appraisal”), and collaboratively respond to it, have better outcomes. This process, known as communal coping, has received little attention in heart failure (HF).ObjectivesTo examine communal coping among patient-caregiver dyads managing HF.MethodsWe conducted semi-structured interviews with 34 dyads. Shared appraisal was measured using we-ratio, as calculated with Linguistic Inquiry Word Count. We-ratio was divided into “high” and “low” for patients and caregivers, and concordance was examined. Thematic analyses were used to explore collaboration.ResultsCaregivers had higher we-ratios than patients (p=.005); 29.6% and 33.3% dyads were concordant on high and low “we-ratio,” respectively. In thematic analyses, we found that 1) dyads collaborated around diet, appointments, and medications, but less around physical activity; 2) dyads collaborated across all illnesses, not just HF; and 3) dyads concordant on high we-ratio reported stronger collaborations.ConclusionsCommunal coping varied by shared appraisal and collaboration. Understanding this variability may help develop tailored self-management interventions.
  • Knowledge among patients with heart failure: A narrative synthesis of
           qualitative research
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Carly Daley, Monirah Al-Abdulmunem, Richard J. HoldenAbstractBackgroundPatients’ knowledge of heart failure (HF) is integral to improved outcomes. However, the HF literature has not adequately explored the nature of patients’ knowledge of HF as part of their lived experience.ObjectivesWe aimed to characterize the nature of patients’ knowledge of HF, in the context of living with the disease.MethodsWe conducted a narrative synthesis of qualitative studies that addressed patients’ knowledge of HF. Studies were systematically searched and retrieved from MEDLINE, CINAHL, PsycINFO and PsycARTICLES databases. Findings were synthesized using an iterative coding process carried out by multiple analysts and reported following Enhancing Transparency in the Reporting of Qualitative Health Research (ENTREQ) criteria.ResultsAnalysis of 73 eligible articles produced five themes: the content that comprises HF knowledge; development of HF knowledge over time; application of HF knowledge for decision making; communication of information between clinicians and patients; and patients’ experience of knowledge.ConclusionThe nature of patients’ knowledge of HF is both explicit and implicit, dynamic, and personal. This multidimensional model of knowledge-in-context calls for equally multidimensional research and intervention design.
  • Information for Authors
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s):
  • Information for Readers
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s):
  • Seasonal variation in physical activity in patients with heart failure
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Afshin Amirpour, Reihaneh Zavar, Javad Shahabi
  • Effects of the discontinuation sequence of norepinephrine and vasopressin
           on hypotension incidence in patients with septic shock: A meta-analysis
    • Abstract: Publication date: November–December 2019Source: Heart & Lung, Volume 48, Issue 6Author(s): Gary Duclos, Karine Baumstarck, Martin Dünser, Laurent Zieleskiewicz, Marc LeoneAbstractBackgroundAlthough the order of vasopressor initiation in patients with septic shock is established, limited information is available on the order of vasopressor discontinuation.MethodsWe performed a meta-analysis of nine studies involving 1245 patients in whom norepinephrine (n = 787) or vasopressin (n = 458) was withdrawn first to compare the risk of hypotension.ResultsThe risk of hypotension increased in patients whom vasopressin was withdrawn first (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.3–8.9; p = 0.01). A sensitivity analysis indicated that this effect was observed in four studies with a high risk of bias (OR, 5.4; 95%CI, 1.3–23.5; p = 0.02) and was not observed in five studies with a low risk of bias (OR, 2.4; 95%CI, 0.6–8.4; p = 0.18).ConclusionOur results suggest that the risk of hypotension is higher in patients with septic shock in whom vasopressin is withdrawn before norepinephrine.
  • Palliative care referral in ST-segment elevation myocardial infarction
           complicated with cardiogenic shock in the United States
    • Abstract: Publication date: Available online 6 November 2019Source: Heart & LungAuthor(s): Tomo Ando, Emmanuel Akintoye, Takeshi Uemura, Oluwole Adegbala, Said Ashraf, Mohit Pahuja, Mohamed Shokr, Hisato Takagi, Cindy L. Grines, Luis Afonso, Alexandros BriasoulisAbstractBackgroundST-segment elevation myocardial infarction complicated with cardiogenic shock (STEMI-CS) is associated with high mortality but the trends of utilization and predictors of palliative care (PC) referral in this population have not been well described.ObjectivesTo investigate the utilization trends and predictors of PC referral in STEMI-CS.MethodsNationwide inpatient sample from 2005–2014 was queried to identify patients with STEMI-CS of age ≥18. PC referral was identified International Classification of Diseases, Ninth Edition Clinical Modification, V66.7.ResultsA total of 33,294 admissions were identified and 1,878 (5.6%) had PC encounter. PC referral group were older and had higher comorbidities. PC consultation increased approximately 10 times over the study period in those who died (from 2.3% to 27.4%) and in those who survived (from 0.21% to 2.83%). In multivariable analysis, age, higher Exlixhauser score, no revascularization, teaching hospital, large bed hospital, mechanical circulatory support use, and lower income status were associated with increased PC referral whereas coronary artery bypass graft was associated with lower PC referral rates. Patients under PC group were more often discharged to an extended care facility and less likely discharged home.ConclusionPC utilization increased substantially during the 10-years study period in the United States in STEMI-CS. Several baseline, procedural, hospital, and socioeconomic factors were associated with PC referral in the setting STEMI-CS.
  • Endotracheal tube cuff pressure change: Proof of concept for a novel
           approach to objective cough assessment in intubated critically ill
    • Abstract: Publication date: Available online 6 November 2019Source: Heart & LungAuthor(s): Matthew Peter O'Neill, Pragasan Dean GopalanAbstractPurposeCough strength assessment aids in predicting extubation failure. Peak expiratory flow rate during cough manoeuvre (CPF) is the gold-standard tool and flow rates of
  • Cricoid pressure during intubation: A systematic review and meta-analysis
           of randomised controlled trials
    • Abstract: Publication date: Available online 2 November 2019Source: Heart & LungAuthor(s): Leigh White, Christopher Thang, Anthony Hodsdon, Thomas Melhuish, Ruan VlokAbstractPurposeThis systematic review and meta-analysis aimed to determine whether cricoid pressure protects against aspiration and whether this technique adversely affects intubating conditions in adult patients.MethodsA systematic review of five databases was performed for randomised controlled trials comparing cricoid pressure to no cricoid or sham cricoid during intubation. The primary outcome was incidence of aspiration and the secondary outcomes included first attempt intubation success, time to intubation, Cormack and Lehane Grade 3 or 4 and difficult intubation.ResultsThe search identified twelve high quality RCTs with 4,862 patients for inclusion. Among four studies reporting the primary outcome, there was no difference (RR=1.18; 95%CI=0.71 to 1.96; I2=0%; p=0.51). Only 3 studies were in patients at high risk of aspiration. There was significantly worse first attempt success (RR= 0.94; 95%CI= 0.89 to 0.99; I2=66%; p=0.02), time to intubation (WMD= 6.77seconds; 95%CI=4.40 to 9.14seconds; I2=97%) and laryngoscopy views (RR=1.69; 95%CI=1.41 to 2.02;I2=1%; p
  • Red cell distribution width and its prediction value of mortality
    • Abstract: Publication date: Available online 1 November 2019Source: Heart & LungAuthor(s): Özge Turgay Yıldırım, Fatih Aydın, Ayşe Hüseyinoğlu Aydın, Ercan Akşit
  • Validation of the Arabic Version of the Minnesota Living with Heart
           Failure Questionnaire
    • Abstract: Publication date: Available online 1 November 2019Source: Heart & LungAuthor(s): Mariam Zahwe, Hussain Isma'eel, Hadi Skouri, Amal Al-Hajje, Samar Rachidi, Hani Tamim, Samar NoureddineAbstractBackgroundThe Minnesota Living with Heart Failure Questionnaire (MLHFQ) is commonly used to measure quality of life (QOL) in patients with heart failure (HF). We examined the psychometric properties and cultural validity of an Arabic version of the MLHFQ.MethodsAn observational cross-sectional study was conducted with 210 adult HF outpatients. Patients were interviewed with the Arabic MLHFQ and the Patient Health Questionnaire (PHQ-9). Cronbach's alpha coefficient and confirmatory factor analysis were conducted. Patients with different NYHA classes and HF-hospitalization histories were compared on QOL to test known-group validity.ResultsThe confirmatory factor analysis yielded 3 factors: physical, emotional, and social. Three items (4, 8, and 15) had low loadings. The overall Cronbach's alpha coefficient was 0.92. There were significant differences in MLHFQ by PHQ-9 categories, NYHA class, and HF-hospitalization history.ConclusionsThis Arabic version of MLHFQ is valid and reliable and can be used in Arabic-speaking Lebanese HF populations.
  • Identifying the optimum chest compression point during cardiopulmonary
    • Abstract: Publication date: Available online 29 October 2019Source: Heart & LungAuthor(s): Davide Olivari, Daria De Giorgio, Francesca Fumagalli, Giuseppe Ristagno
  • Prognostic value of hemodynamics and comorbidities in pulmonary
           hypertension due to advanced heart failure
    • Abstract: Publication date: Available online 23 October 2019Source: Heart & LungAuthor(s): Ruilin Quan, Li Huang, Tao Yang, Wen Li, Qing Gu, Changming Xiong, Jianguo HeAbstractBackgroundThe prognostic predictors of pulmonary hypertension (PH) due to advanced heart failure (HF) have yet to be explored.ObjectivesTo examine the prognostic value of hemodynamics and comorbidities in this patient group.MethodsWe retrospectively enrolled consecutive patients with PH due to advanced HF diagnosed by echocardiography and right heart catheterization. Follow-up was performed every 6 months ± 2 weeks. Primary endpoints were all-cause mortality and heart or lung transplantation.ResultsIn total, 92 patients were included. The mean age was 46.82 years and mean left ventricular ejection fraction (LVEF) was 26.63%. During a median follow-up time of 9.72 months, 66 patients (71.7%) met primary endpoints. Pulmonary arterial compliance (PAC) was a significant predictor for primary endpoints and patients burdened with more than 3 comorbidities had worse prognoses (P = 0.0114).ConclusionsIn these patients, PAC can be a potential prognostic predictor and patients with a higher comorbidity burden have worse outcomes.
  • Quality of life of obstructive sleep apnoea patients receiving continuous
    • Abstract: Publication date: Available online 23 October 2019Source: Heart & LungAuthor(s): Vladimira Timkova, Iveta Nagyova, Sijmen A. Reijneveld, Ruzena Tkacova, Jitse P. van Dijk, Ute BültmannAbstractBackgroundPrevious studies have shown conflicting results on the effect of continuous positive airway pressure (CPAP) on quality of life (QoL) in obstructive sleep apnoea (OSA) patients.ObjectivesTo evaluate the effect of CPAP on QoL in OSA patients compared to sham CPAP, placebo pills, and conservative treatment.MethodsStudies were identified via Web of Knowledge, PubMed, PsychInfo, CINAHL, EMBASE, OpenGrey, and the Cochrane Library. Subgroup analyses and sensitivity analyses were conducted to assess the robustness of the findings.ResultsMeta-analysis of 13 randomised controlled trials showed no significant differences in overall and psychological QoL comparing values of CPAP treated patients with controls; however, physical QoL improved. CPAP significantly affected the overall QoL in studies with controls receiving sham CPAP, parallel design, low risk of bias, and mild OSA patients.ConclusionCPAP treatment may help to improve physical symptoms of OSA, whereas impaired psychological QoL still cannot be alleviated.
  • Leadership message—Age friendly care
    • Abstract: Publication date: Available online 15 October 2019Source: Heart & LungAuthor(s): Linda Wick
  • Comparison of reaction time and functional balance in chronic obstructive
           pulmonary disease and healthy participants
    • Abstract: Publication date: Available online 10 October 2019Source: Heart & LungAuthor(s): Shashank Shekar Singh, Anup Bhat, Aswini Kumar Mohapatra, Mohan K Manu, K VaishaliAbstractBackgroundReaction time is one of the components of functional balance and could contribute to balance impairment. Information regarding this relationship is scant among Chronic Obstructive Pulmonary Disease (COPD) participants.ObjectivesTo compare stepping reaction time between participants with COPD and age; gender-matched healthy individuals to find out whether reaction time in COPD population is affected.MethodsThis cross-sectional study included 41 COPD participants and 41 age and gender-matched healthy individuals. All the participants underwent measurements of stepping reaction time (SRT) and timed up and go test (TUG).ResultsSRT was significantly higher in COPD participants compared to healthy individuals [median of difference- 350 milliseconds (110, 830), p < 0.001]. TUG was significantly higher in COPD participants compared to healthy individuals [median of difference = 2.82 seconds (0.34 and 4.5), p < 0.001].ConclusionsParticipants with COPD exhibit marked increase in SRT and demonstrate a deficiency in functional balance compared to the healthy participants.
  • Time to move: Shifting the ICU paradigm to improve outcomes for survivors
           of critical illness
    • Abstract: Publication date: Available online 24 September 2019Source: Heart & LungAuthor(s): Jill L. Guttormson, Natalie S. McAndrew
  • Predictive risk factors of early onset left ventricular aneurysm formation
           in patients with acute ST-elevation myocardial infarction
    • Abstract: Publication date: Available online 14 September 2019Source: Heart & LungAuthor(s): Zenghui Zhang, Jun GuoAbstractBackgroundLeft ventricular aneurysm (LVA) is a severe complication of ST-elevation myocardial infarction (STEMI) and is associated with poor prognosis due to high mortality. However, predictors of LVA formation in early period are inadequately defined.ObjectivesThe purpose of this study is to determine potential predictors of LVA formation in early period (
  • Physical activity of patients with bronchiectasis compared with healthy
           counterparts: A cross-sectional study
    • Abstract: Publication date: Available online 14 September 2019Source: Heart & LungAuthor(s): Aslihan Cakmak, Deniz Inal-Ince, Hazal Sonbahar-Ulu, Cemile Bozdemir-Ozel, Ozge Ozalp, Ebru Calik-Kutukcu, Melda Saglam, Naciye Vardar-Yagli, Hulya Arikan, Ziya Toros Selcuk, Lutfi CopluAbstractBackgroundA few studies have implied that patients with bronchiectasis have a more inactive lifestyle than healthy counterparts do. The main objective of this study was to compare physical activity (PA) levels subjectively and objectively between patients with bronchiectasis and healthy individuals using an accelerometer and a questionnaire.MethodsThe study included 41 patients with bronchiectasis aged 18–65 years and 35 healthy age- and sex-matched control subjects. The PA level was assessed objectively using a multisensorial PA monitor, the SenseWear Armband (SWA), and subjectively with the International Physical Activity Questionnaire (IPAQ). All participants performed the incremental shuttle walk test (ISWT) for the assessment of exercise capacity. Pulmonary function, dyspnea, severity of bronchiectasis, respiratory and peripheral muscle strength, and quality of life were assessed.ResultsThe pulmonary function test parameters, respiratory and peripheral muscle strength, exercise capacity, step count, moderate- and vigorous-intensity PA duration were significantly lower in patients with bronchiectasis than in the healthy control group (p 
  • Exploring positive aspects of caregiving in family caregivers of adult icu
           survivors from ICU to four months post-ICU discharge
    • Abstract: Publication date: Available online 11 September 2019Source: Heart & LungAuthor(s): JiYeon Choi, Youn-Jung Son, Judith A. TateAbstractBackground: Despite growing attention to the positive meaning from ICU survivorship, little is known about positive experience among family caregivers of ICU survivors.Objectives: To explore positive aspects of caregiving in family caregivers from patients’ ICU admission to 4-month post-ICU discharge.Methods: A secondary analysis of data from 47 family caregivers of ICU patients who self-reported the measure, Positive Aspects of Caregiving (PAC, 11-item, score range 11–55).Results: Family caregivers rated their experience as positive overall across the time points (mean 42.42–44.95). Trends of higher mean PAC scores were observed in caregivers who were older than 50 years of age, parent or sibling of patients, not working, had religious background or preference, and had no financial difficulty. Better social support and psychological responses were associated with PAC.Conclusion: In our sample, family caregivers of ICU survivors rated their caregiving experience as positive during the ICU and post-ICU periods.
  • Extended afternoon naps are associated with hypertension in women but not
           in men
    • Abstract: Publication date: Available online 11 September 2019Source: Heart & LungAuthor(s): Yuhang Yang, Wei Liu, Xiaopeng Ji, Chenjuan Ma, Xiuyan Wang, Kun Li, Junxin LiAbstractBackgroundThe impact of afternoon napping duration on the risk of hypertension has not been well established, particularly with regards to sex and age differences.ObjectiveTo examine the association between afternoon napping duration and hypertension stratified by sex and age among Chinese adults over 45 years of age.MethodsThe 2011–2012 survey of the China Health and Retirement Longitudinal Study (CHARLS) was used, including 7,980 participants. We conducted logistic regression models in the overall sample, and then stratified by sex and age groups.ResultsMiddle-aged and older women who napped over 90 min were 39% and 54% more likely to have hypertension, respectively; however, the associations were not significant in middle-aged and older men.ConclusionExtended afternoon napping (≥90 min) was associated with hypertension in both the middle-aged women and older women but not in men. Future studies are needed to further examine the association and possible mechanisms.
  • Advance directives and intensity of care delivered to hospitalized older
           adults at the end-of-life
    • Abstract: Publication date: Available online 3 September 2019Source: Heart & LungAuthor(s): Marsha H. Tyacke, Jill L. Guttormson, Mauricio Garnier-Villarreal, Kathryn Schroeter, Wendy PeltierAbstractBackgroundOlder adults prefer comfort over life-sustaining care. Decreased intensity of care is associated with improved quality of life at the end-of-life (EOL).ObjectivesThis study explored the association between advance directives (ADs) and intensity of care in the acute care setting at the EOL for older adults.MethodsA retrospective, correlational study of older adult decedents (N = 496) was conducted at an academic medical center. Regression analyses explored the association between ADs and intensity of care.ResultsAdvance directives were not independently predictive of aggressive care but were independently associated with referrals to palliative care and hospice; however, effect sizes were small, and the timing of referrals was late.ConclusionThe ineffectiveness of ADs to reduce aggressive care or promote timely referrals to palliative and hospice services, emphasizes persistent inadequacies related to EOL care. Research is needed to understand if this failure is provider-driven or a flaw in the documents themselves.
  • Floating LVAD hardware in an infected hematoma following a traumatic fall
    • Abstract: Publication date: Available online 30 August 2019Source: Heart & LungAuthor(s): Grace Lee, Sarah D. Schettle, John M. StulakAbstractLeft ventricular assist devices (LVAD) are used to support advanced heart failure patients who have failed optimal medical management, meet LVAD criteria, and are deemed to be appropriate surgical candidates. LVAD patients are further advised on symptoms that should prompt notification to the implanting center and are encouraged to contact their LVAD team with device questions and concerns due to morbidity risks unique to this patient population. Mechanical disruption of internal LVAD components is rare and typically requires hospitalization and potentially surgical intervention. External trauma to the LVAD resulting in driveline fracture, torn LVAD outflow grafts, pump displacement, and a kinked inlet cannula have been described.1 Because these occurrences are rare and often unexpected, identification of the root cause may not always be readily apparent. We describe a previously unreported presentation of a patient supported with an LVAD for more than 4 years who was found to have a broken and dislodged LVAD outflow cuff floating in an abdominal hematoma without pump failure.
  • Response to letter to the editor: Seasonal variation in physical activity
           in patients with heart failure
    • Abstract: Publication date: Available online 29 August 2019Source: Heart & LungAuthor(s): Leonie Klompstra, Tiny Jaarsma, Anna Strömberg, Martje H.L. Van der Wal
  • Comparison of oxidant/antioxidant balance in COPD and non-COPD smokers
    • Abstract: Publication date: Available online 23 August 2019Source: Heart & LungAuthor(s): Serdar Kalemci, Aydın Sarıhan, Arife Zeybek, Abdullah Şimşek, Nihat Taşdemir
  • Doing more to serve our patients
    • Abstract: Publication date: Available online 23 August 2019Source: Heart & LungAuthor(s): Kimberly Nelson
  • Body composition changes assessment by bioelectrical impedance vectorial
           analysis in right heart failure and left heart failure
    • Abstract: Publication date: Available online 15 August 2019Source: Heart & LungAuthor(s): Dulce González-Islas, Estefanía Arámbula-Garza, Arturo Orea-Tejeda, Lilia Castillo-Martínez, Candace Keirns-Davies, Fernanda Salgado-Fernández, Luis Hernández-Urquieta, Samantha Hernández-López, Yuridia Pilotzi-MontielAbstractBackgroundHeart Failure (HF) patients developed changes in body composition as overhydration, muscle-skeletal wear and cardiac cachexia (CC). The possible factors involved in the development of CC in Right Heart Failure (RHF) patients are venous congestion, nutrient malabsorption. However, in HF, the overhydration obscure the loss of fat-free mass and difficult the body composition assessment. Bioelectrical impedance vectorial analysis (BIVA) is a method validated and used for hydration status and body composition assessment in HF. The aim of this study was to investigate the body compositions changes assessment by BIVA in the subjects with and without RHF and evaluate the risk factors for devolvement CC in HF subjects.Material and methodsProspective cohort study. Subjects with confirmed diagnoses of HF,>18 years old without CC according to BIVA criteria were included. Subjects with congenital heart disease, cancer, HIV, and end-stage renal disease were excluded. Body composition was an assessment by BIVA. 288 HF patients were evaluated. RHF subjects had an impedance vector reduction (9.26 dR/H and -1.92 dXc/H, T2=14.9, D = 0.45, p
  • Exploring the experiences of individuals with an insertable cardiac
           monitor: Making the decision for device insertion
    • Abstract: Publication date: Available online 7 August 2019Source: Heart & LungAuthor(s): Aprel F. Ventura, Carolyn E. Horne, Patricia B. Crane, Michele A. Mendes, Samuel SearsAbstractBackgroundLittle is known about the decision-making process for insertable cardiac monitors (ICM) in those with suspected arrhythmias.ObjectiveThe purpose of this qualitative study was to describe how individuals make a decision to insert an ICM.MethodsA qualitative descriptive design was used. Data were analyzed using content analysis and constant comparison. NVivo 10 was used for data grouping and patterns.ResultsParticipants (N = 12) ranged in age from 41to 95. Most (n = 7) had the device inserted because of syncope or atrial fibrillation (AF), and others (n = 5) for cryptogenic stroke. Three categories emerged: pre-decision, definitive decision, and deliberated decision. Event symptoms, including physical, cognitive and emotional, and trust emerged as factors in decision-making.ConclusionsThose who perceived their experience as life-threatening, trusted the healthcare provider and assented to the ICM insertion. Conversely, those who perceived symptoms as episodic, used other strategies to resolve symptoms prior to making the decision for insertion.
  • Comparison of oxidant/antioxidant balance in COPD and non-COPD smokers
    • Abstract: Publication date: Available online 29 July 2019Source: Heart & LungAuthor(s): Yusuf Aydemir, Özlem Aydemir, Aysun Şengül, Adil Can Güngen, Hikmet Çoban, Canatan Taşdemir, Hasan Düzenli, Abidin ŞehitoğullarıAbstractBackground/aimOxidative stress plays an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). Smoking is the leading source of oxidants in lungs. However, it is currently unknown why some individuals are more resistant to the detrimental effects of smoking and do not develop COPD. The aim in this study is to measure and compare the oxidant/antioxidant balance between in non-COPD individuals who smoke and COPD patients who smoke.Materials and methodsIncluded in the study were 137 patients with COPD and 102 healthy individuals. Participants were divided into groups as COPD patients (former and current smokers), non-COPD individuals who smoke and non-smokers healthy persons. In the following stage, the total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) levels were measured in serum for all participants.ResultsIn the current-smoker COPD group, the level of oxidant status were significantly higher than the former-smoker COPD group (p 
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Heriot-Watt University
Edinburgh, EH14 4AS, UK
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