Diagnosis and Management of Acute Congestive Heart Failure in the Intensive Care Unit

1989 ◽  
Vol 4 (2) ◽  
pp. 84-92 ◽  
Author(s):  
Gary S. Francis ◽  
Stephen L. Archer
Keyword(s):  
Heart Failure ◽  
Intensive Care Unit ◽  
Congestive Heart Failure ◽  
Intensive Care ◽  
Diagnosis And Management

Spironolactone

1999 ◽  
Vol 18 (3) ◽  
pp. 43-46 ◽  
Author(s):  
Barbara Noerr
Keyword(s):  
Heart Failure ◽  
Intensive Care Unit ◽  
Congestive Heart Failure ◽  
Intensive Care ◽  
Side Effects ◽  
Chronic Lung Disease ◽  
Neonatal Intensive Care ◽  
Age Groups ◽  
Extracellular Fluid ◽  
Appropriate Use

DIURETICS ARE COMMONLY USED IN the neonatal intensive care unit (NICU) to remove excess extracellular fluid secondary to various diseases, such as chronic lung disease (CLD) and congestive heart failure (CHF). Diuretics are among the most used of all medications across age groups. They are also among the most abused medications, with the potential for many untoward side effects.3,4 Thus, NICU nurses must understand their appropriate use, their possible consequences, and the monitoring required when using them. Furosemide and chlorothiazide have been reviewed previously (see Neonatal Network, 1991, 9(7): 65–67, and 1993, 12(7): 69–70, respectively). This column focuses on spironolactone use.

scholarly journals Incidence, Risk Factors and Outcomes of New Onset Supraventricular Arrhythmias in African American Patients with Severe Sepsis

2016 ◽  
Vol 26 (2) ◽  
pp. 205 ◽  
Author(s):  
O'Dene Lewis ◽  
Julius Ngwa ◽  
Richard F. Gillum ◽  
Alicia Thomas ◽  
Wayne Davis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Supraventricular Arrhythmias ◽  
Incidence Risk ◽  
New Onset

<p><strong>Purpose</strong>: New onset supraventricular arrhythmias (SVA) are commonly reported in mixed intensive care settings. We sought to determine the incidence, risk factors and outcomes of new onset SVA in African American (AA) patients with severe sepsis admitted to medical intensive care unit (MICU).</p><p><strong>Methods:</strong> Patients admitted to MICU between January 2012 through December 2012 were studied. Patients with a previous history of arrhythmia or with new onset of ventricular arrhythmia were excluded. Data on risk factors, critical care interventions and outcomes were obtained.</p><p><strong>Results:</strong> One hundred and thirty-one patients were identified. New onset SVA occurred in 34 (26%) patients. Of those 34, 20 (59%) had atrial fibrillation (AF), 6 (18%) had atrial flutter and 8 (24%) had other forms of SVA. Compared with patients without SVA, patients with new onset SVA were older (69 ± 12 yrs vs 59 ± 13 yrs, P=.003), had congestive heart failure (47% vs 24%, P=.015) and dyslipidemia (41% vs 15%, P=.002). Additionally, they had a higher mean mortality prediction model (MPM II) score (65 ± 25 vs 49 ± 26, P=.001) and an increased incidence of respiratory failure (85% vs 55%, P=.001). Hospital mortality in patients with new onset SVA was 18 (53%) vs 30 (31%); P=.024; however, in a multivariate analysis, new onset SVA was associated with nonsignificantly increased odds (OR 2.58, 95% CI 0.86-8.05) for in-hospital mortality.</p><p><strong>Conclusion:</strong> New onset SVA was prevalent in AA patients with severe sepsis and occurred more frequently with advanced age, increased severity of illness, congestive heart failure, and acute respiratory failure; it was associated with higher unadjusted in hospital mortality. However, after multiple adjustments, new onset SVA did not remain an independent predictor of mortality. <em>Ethn Dis.</em>2016;26(2):205-212; doi:10.18865/ ed.26.2.205</p>

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