Frequency of Desaturation and Association With Hemodynamic Adverse Events During Tracheal Intubations in PICUs

Objectives: Oxygen desaturation during tracheal intubation is known to be associated with adverse ICU outcomes in critically ill children. We aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation–associated events. Design: Retrospective cohort study as a part of the National Emergency Airway Registry for Children Network’s quality improvement project from January 2012 to December 2014. Setting: International PICUs. Patients: Critically ill children younger than 18 years undergoing primary tracheal intubations in the ICUs. Interventions: tracheal intubation processes of care and outcomes were prospectively collected using standardized operational definitions. We defined moderate desaturation as oxygen saturation less than 80% and severe desaturation as oxygen saturation less than 70% during tracheal intubation procedures in children with initial oxygen saturation greater than 90% after preoxygenation. Adverse hemodynamic tracheal intubation–associated event was defined as cardiac arrests, hypo or hypertension requiring intervention, and dysrhythmia. Measurements and Main Results: A total of 5,498 primary tracheal intubations from 31 ICUs were reported. Moderate desaturation was observed in 19.3% associated with adverse hemodynamic tracheal intubation–associated events (9.8% among children with moderate desaturation vs 4.4% without desat...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

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Authors: Mustafa ER, Tudoraşcu DR, Giucă A, Toader DM, Foarfă MC, Puiu I, Istrate-Ofiţeru AM Abstract A 46-year-old female diagnosed several years ago with arterial hypertension and an ischemic stroke with significant recovery was admitted for dyspnea on usual physical activity and fatigue. Physical examination revealed signs of heart failure with crackles on both lung bases, distented jugular veins, accentuated pulmonic valve closure (P2) and tricuspid regurgitation murmur. Echocardiography identified a large tumor in the left atrium, suggestive of atrial myxoma, which caused a severe functional mitral stenosi...
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
The Viborg Vascular (VIVA) randomised controlled trial described a population screening program for abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD), and hypertension, and provided subsequent lifestyle advice and recommendations for medical and interventional treatment in men aged 65 –74 years.1 Some 50,156 men participated in VIVA, and a significant reduction in all cause mortality was found from 10.8% in the control group to 10.2% in the intervention group after a mean follow up of 4.4 years.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Invited Commentary Source Type: research
We sincerely thank Dr. Kawada for his interest in our study titled ‘Incident stroke among Ghanaians with hypertension and diabetes: a multicenter, prospective study’. The aim of our study [1] was to assess the rates and determinants of incident stroke among a prospective, hospital-based Ghanaian cohort with hypertension and or type 2 diabetes mellitus. In this regard, our study was not designed to “evaluate the risk of hypertension and diabetes for incident stroke” as specified by our correspondents.
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research
Sarfo et al. conducted a prospective study to evaluate the risk of hypertension and diabetes for incident stroke [1]. The authors recognized 54 events of stroke, and incidence rates (95% confidence intervals [CIs]) of stroke per 1000 person-years in patients with diabetes and hypertension, only hypertension and only diabetes were 16.64 (10.58 –25.00), 13.77 (9.33–19.64) and 9.81 (3.59–21.74), respectively. In addition, adjusted hazard ratios (95% CI) of previous cigarette smoking and physical inactivity for incident stroke were 2.59 (1.18–5.67) and 1.81 (1.06–3.10).
Source: Journal of the Neurological Sciences - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research
CONCLUSIONS Parasitological testing for S. mansoni should be indicated in endemic areas when this pattern of alterations is detected.
Source: Revista da Sociedade Brasileira de Medicina Tropical - Category: Tropical Medicine Source Type: research
Abstract Objective: We aimed to analyze whether patent foramen ovale (PFO) closure reduces the risk of stroke, assessing also some safety outcomes after the publication of a new trial. Introduction: The clinical benefit of closing a PFO has been an open question, so it is necessary to review the current state of published medical data in regards to this subject. Methods: MEDLINE, EMBASE, CENTRAL/CCTR, SciELO, LILACS, Google Scholar and reference lists of relevant articles were used to search for randomized controlled trials (RCTs) that reported any of the following outcomes: stroke, death, major bleeding or atrial fibrilla...
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract This paper presents a case study of a patient that underwent surgery for a ruptured abdominal aneurysm. The postoperative course was complicated by resistant hypertension and tachycardia. A suprarenal mass was detected in the computed tomography scan with radiological suspicion of pheochromocytoma. Few cases of pheochromocytoma coexisting with aneurysms have been reported. Management of cardiovascular stability is crucial in such cases. Despite the lack of evidence, pheochromocytomas might have a role in the etiology of aortic aneurysms.
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
AbstractWe explored the impact of gender and cardiovascular risk factors (RF) in the distribution and burden of coronary and extra-coronary atherosclerotic plaques among patients undergoing ECG-gated thoracoabdominal computed tomography angiography (CTA) from the supra-aortic trunks to the femoral arteries. We included a consecutive cohort of patients who underwent ECG-gated thoracoabdominal aortic CTA from the supra-aortic trunks to the pubic symphysis. We evaluated the number of coronary segments with plaques [segment-involvement score (SIS)]; and the extra-coronary atherosclerotic plaque burden, comprising the aorta and...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
A new scoring system attempts to measure whether clinical-trial results are a good fit with individual patients in clinical practice, using a major hypertension trial as a test case.Medscape Medical News
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Cardiology News Source Type: news
Conclusion: These findings are important to support policies that aim to achieve the World Health Organization ’ s goal of reducing hypertension by 25% over the next decade.
Source: Revista Brasileira de Epidemiologia - Category: Epidemiology Source Type: research
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