scholarly journals Iatrogenic tracheal rupture after extubation in the context of acute decompensated heart failure and cardiac device implantation: a case report

2021 ◽  
Vol 2021 (7) ◽  
Author(s):  
Nika Kuridze ◽  
Kakhaber Etsadashvili ◽  
Eteri Minadze ◽  
Nani Gonjilashvili ◽  
Mikheil Tsverava
Keyword(s):  
Subcutaneous Emphysema ◽  
Acute Decompensated Heart Failure ◽  
Clinical Manifestations ◽  
Well Being ◽  
Decompensated Heart Failure ◽  
Cardiac Resynchronization ◽  
Airway Complication ◽  
Cardiac Device ◽  
Tracheal Rupture ◽  
Satisfactory Condition

ABSTRACT Iatrogenic tracheal rupture is a life-threatening airway complication. It has a very low reported incidence and is more prevalent in women and patients over 50 years of age. The most frequent clinical manifestations of tracheal injury are subcutaneous emphysema and respiratory distress. We report a case of a 65-year-old woman with cardiac resynchronization therapy defibrillator implantation under general anesthesia. Shortly after extubation, dyspnea and subcutaneous emphysema appeared. The X-ray showed pneumomediastinum, pneumopericardium and pneumoperitoneum. The tracheal rupture was confirmed by bronchoscopy. After conservative treatment, the patient's well-being improved, and she was discharged from the hospital in a satisfactory condition.

Fluid Management Strategies in Heart Failure

2012 ◽  
Vol 32 (2) ◽  
pp. 20-32 ◽  
Author(s):  
Nancy M. Albert
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Fluid Management ◽  
Management Strategies ◽  
Signs And Symptoms ◽  
Decompensated Heart Failure ◽  
Performance Measure ◽  
Fluid Retention ◽  
Cardiac Device ◽  
Nurse Administrators

In patients with chronic heart failure, fluid retention (or hypervolemia) is often the stimulus for acute decompensated heart failure that requires hospitalization. The pathophysiology of fluid retention is complex and involves both hemodynamic and clinical congestion. Signs and symptoms of both hemodynamic and clinical congestion should be assessed serially during hospitalization. Core heart failure drug and cardiac device therapies should be provided, and ultrafiltration may be warranted. Critical care, intermediate care, and telemetry nurses have roles in both assessment and management of patients hospitalized with acute decompensated heart failure and fluid retention. Nurse administrators and managers have heightened their attention to fluid retention because the Medicare performance measure known as the risk-standardized 30-day all-cause readmission rate after heart failure hospitalization can be attenuated by fluid management strategies initiated by nurses during a patient’s hospitalization.

Anesthetic Considerations in Pediatric Patients With Acute Decompensated Heart Failure

2021 ◽  
pp. 108925322110449
Author(s):  
Roby Sebastian ◽  
Sana Ullah ◽  
Pablo Motta ◽  
Bibhuti Das ◽  
Luis Zabala
Keyword(s):  
Heart Failure ◽  
Congenital Heart ◽  
Pediatric Patients ◽  
Perioperative Management ◽  
Acute Decompensated Heart Failure ◽  
Clinical Manifestations ◽  
Decompensated Heart Failure ◽  
Morbidity And Mortality ◽  
Significant Morbidity ◽  
Anesthetic Considerations

Acute decompensated heart failure (ADHF) in pediatrics is a significant cause for morbidity and mortality in children. Congenital heart disease and cardiomyopathy are the leading etiologies of ADHF. It is common for these children to undergo diagnostic, therapeutic, or surgical procedure under anesthesia, which may be associated with significant morbidity and mortality. The importance of preanesthetic multidisciplinary planning with all involved teams, including anesthesia, cardiology, intensive care, perfusion, and cardiac surgery, cannot be emphasized enough. In order to safely manage these patients, it is imperative for the anesthesiologist to understand the complex pathophysiological interactions between cardiopulmonary systems and anesthesia during these procedures. This review discusses the etiology, pathophysiology, clinical manifestations, and perioperative management of these patients.

scholarly journals Rapid Fire Abstract session: assessment of systolic function: clinical perspectives and future directions782How the echocardiographic parameters of left ventricular function change during the first year after myocardial infarction when the ejection fraction remains normal?783Blunted increase in LV longitudinal deformation during exercise contributes to the transition from an asymptomatic stage to clinically overt HFpEF784A septal flash induced by right ventricular pacing is associated with left ventricular dysfunction and remodeling785Assessment of right ventricular systolic function in patients with significant functional tricuspid regurgitation: longitudinal parameters increase accuracy and predict cardiovascular outcomes786Effect of left ventricular augmentation with alginate biopolymer on right heart function787Left ventricular mechanics: novel tools to evaluate function and dyssynchrony in controls and cardiac resynchronization therapy candidates788How does regional wall thickness influence strain measurements?789TAPSE-estimated right ventricular systolic dysfunction predicts mortality among acute decompensated heart failure with preserved ejection fraction patients: a prospective study in a secondary center

2015 ◽  
Vol 16 (suppl 2) ◽  
pp. S130-S132 ◽  
Author(s):  
T Baron ◽  
W Kosmala ◽  
S I Sarvari ◽  
A Garcia Martin ◽  
S I Dumitrescu ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Right Ventricular ◽  
Acute Decompensated Heart Failure ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Ventricular Mechanics ◽  
Functional Tricuspid Regurgitation

scholarly journals Predictors of Global Well-Being and Dyspnea Changes during Treatment for Acute Decompensated Heart Failure

2017 ◽  
Vol 23 (8) ◽  
pp. S15
Author(s):  
Nicholas S. Hendren ◽  
Mark H. Drazner ◽  
W.H. Wilson Tang ◽  
Justin L. Grodin
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Well Being ◽  
Decompensated Heart Failure

Assessing Acute Decompensated Heart Failure – Strategies and Tools

2012 ◽  
Vol 8 (2) ◽  
pp. 128
Author(s):  
Ali Vazir ◽  
Martin R Cowie ◽  
◽  
Keyword(s):  
Heart Failure ◽  
Acute Decompensated Heart Failure ◽  
Pulse Contour Analysis ◽  
Decompensated Heart Failure ◽  
Rapid Onset ◽  
Clinical Syndrome ◽  
Response To Therapy ◽  
Contour Analysis ◽  
Physiological Variables ◽  
Co Morbidity

Acute heart failure – the rapid onset of, or change in, signs and/or symptoms of heart failure requiring urgent treatment – is a serious clinical syndrome, associated with high mortality and healthcare costs. History, physical examination and early 2D and Doppler echocardiography are crucial to the proper assessment of patients, and will help determine the appropriate monitoring and management strategy. Most patients are elderly and have considerable co-morbidity. Clinical assessment is key to monitoring progress, but a number of clinical techniques – including simple Doppler and echocardiographic tools, pulse contour analysis and impedance cardiography – can help assess the response to therapy. A pulmonary artery catheter is not a routine monitoring tool, but can be very useful in patients with complex physiology, in those who fail to respond to therapy as would be anticipated, or in those being considered for mechanical intervention. As yet, the serial measurement of plasma natriuretic peptides is of limited value, but it does have a role in diagnosis and prognostication. Increasingly, the remote monitoring of physiological variables by completely implanted devices is possible, but the place of such technology in clinical practice is yet to be clearly established.

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