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Palliative Care Clinicians Caring for Patients Before and After Continuous Flow-Left Ventricular Assist Device
Left ventricular assist devices (LVADs) are an available treatment option for carefully-selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. While survival and quality of life improve with LVADs compared to medical therapy, complications persist including bleeding, infection, and stroke.
Source: Journal of Pain and Symptom Management - July 12, 2017 Category: Palliative Care Authors: Sara E. Wordingham, Colleen K. McIlvennan, Timothy J. Fendler, Amy L. Behnken, Shannon M. Dunlay, James N. Kirkpatrick, Keith M. Swetz Source Type: research

Risk stratification and clinical outcomes after surgical pulmonary valve replacement
ConclusionPatients undergoing PVR at larger RV volumes had similar survival but more overall CAE. A larger study population with a longer follow-up will be required to determine if early PVR provides survival benefit in the long-term.
Source: American Heart Journal - October 4, 2018 Category: Cardiology Source Type: research

Looking Past Dementia Reveals Hidden Life Threats
Conclusion Acute delirium is commonly underdiagnosed, and can be masked by chronic alterations in cognition and mentation. Delirium has many causes, and can be assessed using the acronym DELIRIUM. The most common presentations suggesting delirium over dementia are short-term memory loss, rapid fluctuation in condition, acute alteration, and a condition present that may be responsible for delirium. Management includes searching for causes of acute alteration in mental status, negating environmental factors of delirium, and—only when necessary—reducing the patient’s threat to themselves or providers by using butyrophen...
Source: JEMS Special Topics - August 13, 2018 Category: Emergency Medicine Authors: Joseph K. Mesches, NRP, FP-C Tags: Exclusive Articles Patient Care Source Type: news

Hispanic Hospice Utilization: Integrative Review and Meta-analysis.
Abstract Hospice is patient-centered end-of-life care. Hispanics are underrepresented among hospice patients (7.1%) relative to the U.S. population (17%). We conducted a systematic review of the literature and meta-analysis to understand this underrepresentation further. In palliative care, Hispanic hospice enrollment is comparable to that of non-Hispanic Whites (NHWs) (RR 1.02, 95% CI: 0.93-1.12; z=0.49; p = .627). However, in cases of heart failure (OR 0.49, 95% CI 0.37-0.66) and stroke (OR 0.77, 95% CI 0.63-0.94), Hispanics are much less likely to use hospice than NHWs. Cancer studies are mixed, but in meta-ana...
Source: Journal of Health Care for the Poor and Underserved - May 30, 2019 Category: International Medicine & Public Health Authors: Rising ML, Hassouneh DS, Lutz KF, Berry P, Lee CS Tags: J Health Care Poor Underserved Source Type: research

Medical Management of LVAD Patients: A Practical Guide for the Non-Expert Clinician
This article provides a concise overview of the medical management of LVAD patients aimed for non-expert clinicians. Our presentation includes the basics of LVAD physiology, design and operation, patient selection, patient assessment, medical management, adverse event identification and management, multidisciplinary care, and management of special circumstances such as non-cardiac surgery, cardiac arrest, and end-of-life care. The clinical examination of LVAD patients is unique in terms of blood-pressure and heart-rate assessment, LVAD ‘hum’ auscultation, driveline/insertion-site inspection, and device-parameter record...
Source: Canadian Journal of Cardiology - October 5, 2019 Category: Cardiology Source Type: research

Measuring the success of interventions for caregivers: a focussed systematic review
Purpose of review The selection and application of outcome measures are fundamental steps in the research process because they inform decisions around intervention efficacy. We aimed to describe the outcomes used in trials of supportive interventions for adult caregivers of people with three exemplar life-limiting conditions: heart failure, dementia or stroke. Recent findings We performed a focussed review of 134 published trials that included interventions designed to improve caregivers’ health and wellbeing and/or ability to function in their caring role. We extracted and categorized all caregiver outcomes describ...
Source: Current Opinion in Supportive and Palliative Care - November 4, 2019 Category: Palliative Care Tags: END OF LIFE MANAGEMENT: Edited by Gustavo De Simone and Bridget Johnston Source Type: research

Medical Management of Left Ventricular Assist Device Patients: A Practical Guide for the Nonexpert Clinician
This article provides a concise overview of the medical management of LVAD patients for nonexpert clinicians. Our presentation includes the basics of LVAD physiology, design, and operation, patient selection and assessment, medical management, adverse event identification and management, multidisciplinary care, and management of special circumstances, such as noncardiac surgery, cardiac arrest, and end-of-life care. The clinical examination of LVAD patients is unique in terms of blood pressure and heart rate assessment, LVAD “hum” auscultation, driveline and insertion site inspection, and device parameter recording. Im...
Source: Canadian Journal of Cardiology - February 7, 2020 Category: Cardiology Source Type: research

Outpatient Cardiac Palliative Care Reduces Healthcare Utilization
The American Heart Association and American Stroke Association have put forth statement recommending early and continuous access to palliative care for patients with heart disease. There is a national shortage of palliative care providers, and often outpatient palliative care clinics are not profitable to institutions with billing alone. However, early integration of palliative care has been proven to improve the quality of life of patients with advanced heart failure. Other studies have suggested that general palliative care has cost savings to hospital systems.
Source: The Journal of Heart and Lung Transplantation - March 31, 2020 Category: Transplant Surgery Authors: T.A. Barrett Tags: (907) Source Type: research

Development of an indicator set for the evaluation of the population-based integrated healthcare model 'Gesundes Kinzigtal' (Healthy Kinzigtal).
CONCLUSION: On the basis of a broadly based research and participatory development process, a set of indicators has been developed that enables comprehensive evaluation of the regional quality of care of cross-indication, integrated care models focusing on common diseases. In order to be able to increasingly evaluate aspects of care coordination and patient orientation, health promotion as well as nursing, palliative and emergency care in the future, it would be helpful if routine data were collected or made accessible in these areas as well. PMID: 32467041 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - May 30, 2020 Category: Health Management Tags: Z Evid Fortbild Qual Gesundhwes Source Type: research

Outpatient Cardiac Palliative Care Reduces Healthcare Utilization (RP524)
The American Heart Association and American Stroke Association have put forth policy statements recommending early and continuous access to palliative care for patients with advanced heart disease. Early integration of palliative care has been proven to improve the quality of life of patients with advanced heart failure. Other studies have suggested that palliative care in general has cost savings to hospital systems.
Source: Journal of Pain and Symptom Management - June 20, 2020 Category: Palliative Care Authors: Todd Barrett Source Type: research

The fate of active left ‐side infective endocarditis with operative indication in absence of valve surgery
ConclusionThe mortality of this cohort of patients is extremely high. A multidisciplinary evaluation is of paramount importance in the decision ‐making process with shared responsibility for denial of operative options. In a perspective of correct healthcare resources allocation an early palliative care consult may need to be considered in some of those patients.
Source: Journal of Cardiac Surgery - August 20, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Davide Carino, Alejandro Fern ández‐Cisneros, Marta Hernández‐Meneses, Elena Sandoval, Jaume Llopis, Carlos Falces, José M. Miró, Eduard Quintana, Grup d'Estudi d'Endocarditis Infecciosa de l'Hospital Clínic de Barcelona Tags: ORIGINAL ARTICLE Source Type: research

Impact of obesity on acute complications of catheter ablation for cardiac arrhythmia.
ConclusionIn this study, obesity did not have a significant impact on the incidence of periprocedural complications after CA for cardiac arrhythmia.This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - February 4, 2022 Category: Cardiology Authors: Niklas Schenker, Flurina Blumenthal, Samer Hakmi, Christine Lemes, Shibu Mathew, Laura Rottner, Peter Wohlmuth, Bruno Rei ßmann, Andreas Rillig, Andreas Metzner, Stephan Willems, Feifan Ouyang, Karl‐Heinz Kuck, Tilman Maurer Tags: ORIGINAL ARTICLE Source Type: research

Impact of obesity on acute complications of catheter ablation for cardiac arrhythmia
ConclusionIn this study, obesity did not have a significant impact on the incidence of periprocedural complications after CA for cardiac arrhythmia.
Source: Journal of Cardiovascular Electrophysiology - February 11, 2022 Category: Cardiology Authors: Niklas Schenker, Flurina Blumenthal, Samer Hakmi, Christine Lemes, Shibu Mathew, Laura Rottner, Peter Wohlmuth, Bruno Rei ßmann, Andreas Rillig, Andreas Metzner, Stephan Willems, Feifan Ouyang, Karl‐Heinz Kuck, Tilman Maurer Tags: ORIGINAL ARTICLE Source Type: research

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