Nesiritide in the management of congestive heart failure: A retrospective study of hemodynamics and adverse events in a community teaching hospital

2003 ◽  
Vol 73 (2) ◽  
pp. P63-P63
Author(s):  
S. Rasty ◽  
S. H. Mohammed
2021 ◽  
pp. 014556132110257
Author(s):  
Dongho Shin ◽  
Andrew Ma ◽  
Yvonne Chan

Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients.


2020 ◽  
Vol 56 (1) ◽  
pp. 37-41
Author(s):  
Ron Achiel ◽  
Andy Carver ◽  
Robert A. Sanders

ABSTRACT We described the use of IV nitroglycerin as adjunctive therapy in three canine patients with left congestive heart failure secondary to degenerative mitral valve disease. All three dogs were admitted for signs of respiratory distress and all were determined to be in left congestive heart failure by history, exam findings, thoracic radiographs, and echocardiography. In addition to standard therapy for left congestive heart failure, IV nitroglycerin was administered as a constant rate infusion at a dose of 1–6 mcg/kg/min. No adverse events attributable to the drug were noted. This is the first reported use of IV nitroglycerin in clinical veterinary patients. Further studies are warranted to investigate the safety, efficacy, and optimal dosing of IV nitroglycerin infusions in dogs with left congestive heart failure.


2016 ◽  
Vol 22 (8) ◽  
pp. S93
Author(s):  
Uri Goldberg ◽  
Sameera Ishtiaq ◽  
Mohamed Alibakhiet ◽  
Wazhma Nasiri ◽  
Rajat Mukherji ◽  
...  

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2146-2146 ◽  
Author(s):  
Ehab Atallah ◽  
Jean-Bernard Durand ◽  
Hagop Kantarjian ◽  
Elias Jabbour ◽  
Susan O’Brien ◽  
...  

Abstract Background: A recent report suggested that imatinib is cardiotoxic and can lead to severe left ventricular dysfunction and heart failure. Study Aim: To evaluate the incidence of congestive heart failure (CHF) in pts receiving imatinib. Methods: We reviewed all Grade III and IV cardiac or what could be considered cardiac-related adverse events (eg, shortness of breath, dyspnea on exertion, edema, etc) occurring in pts on clinical trials at MDACC involving imatinib. Results: 1276 pts were enrolled on clinical trials with imatinib from 7/28/1998 to 7/27/2006. After reviewing all reported adverse events, particularly those that could be considered of at least possible cardiac origin, 22 pts (1.8%) were identified as having symptoms that could be attributed to CHF. The median age for these 22 pts was 70 yrs (range, 49 to 83 yrs); 12 were male. Their diagnosis at the time of imatinib was started was chronic myeloid leukemia in chronic phase (11 of 561 pts, 1.96%), accelerated phase (4 of 384 pts, 1.04%), or blast phase (2 of 123 pt, 1.62%), myeloproliferative disorder (4 of 124 pts, 3.2%), acute lymphoblastic leukemia (1 of 74 pts, 1.35%) and none in 10 pts with c-kit positive AML. Twelve pts (55%) had received prior interferon therapy and 3 pts had received anthracyclins. The median time from start of imatinib therapy to a cardiac adverse event was 162 days (2–2045 days). Imatinib dose at the time of AE was 300mg/d in 1 pt, 400mg/d in 8 pts, 600mg/d in 9 pts, and 800mg/d in 5 pts. At the time these events were reported, 8 were considered possibly or probably related to imatinib. Eighteen pts had previous medical conditions predisposing to cardiac disease: CHF (6 pts, 27%), DM (6 pts, 27%), hypertension (10 pts, 45%), coronary artery disease (CAD) (8 pts, 36%), arrhythmia (3 pts, 14%) and cardiomyopathy (1 pt 5%). Fifteen pts had an echocardiogram or MUGA scan at the time of the event, and 9 of them had documented low ejection fractions (<50%); in only 2 of these 9 pts was there an echocardiogram prior to imatinib (LVEF >50% in both). Of the 9 pts with low ejection fractions at the time of the event , 6 had prior cardiac conditions (3 CAD, 2 CHF and 1 cardiomyopathy), one patient’s low EF etiology could not be determined as no further cardiac evaluation was performed because of progressive disease, and one pt was on anagrelide prior to the event. Eleven of the 22 pts continued imatinib therapy with dose adjustments and management for the CHF symptoms with no further complications. Conclusions: Imatinib therapy as a causal factor of CHF is uncommon and is mainly seen in elderly patients with pre-existing cardiac conditions. Patients with a previous cardiac history should be monitored closely and treated aggressively with diuretics if they develop fluid retention.


2015 ◽  
Vol 83 (3) ◽  
pp. 211-216 ◽  
Author(s):  
Luis Meave Gutiérrez-Mendoza ◽  
Abraham Torres-Montes ◽  
Manuel Soria-Orozco ◽  
Aldanely Padrón-Salas ◽  
María Elizabeth Ramírez-Hernández

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