Admission of COVID-19 Patients to the Cardiac Care Unit: Challenges and Solutions

Abstract Funding Acknowledgements Type of funding sources: None. Background. Delirium is frequent in patients admitted to critical care units. Its incidence after transcatheter aortic valve implantation (TAVI) is up to 30%. Clinical and demographic factors have been related to delirium, but echocardiographic parameters have not been evaluated. Purpose. The aim of this study was to assess clinical and echocardiographic predictors of delirium in patients admitted to an acute cardiac care unit (ACCU) after transfemoral TAVI. Methods. 501 patients admitted to ACCU after TAVI were included. Delirium was evaluated by Confusion Assessment Method. Clinical cardiovascular and geriatric conditions were assessed, as well as echocardiographic parameters. Results. The incidence of delirium was 22% (110 patients). Delirium was associated with age (83.8 ± 4.6 vs 82.6 ± 6.1 years, p = 0.026), dyslipidaemia (50.0% vs 61.4%, p = 0.032), prior peripheral arterial disease (11.9% vs 5.4%, p = 0.017) and cognitive impairment (10.0% vs 1.8%, p < 0.001). There was no relationship to gender, other cardiovascular risk factors or geriatric conditions. Table shows echocardiographic parameters at baseline and after TAVI, with no statistical association with delirium. Conclusion. Delirium is a common complication after TAVI in ACCU. Age, the absence of dyslipidaemia, or the presence of cognitive impairment or prior peripheral arterial disease are clinical predictors of delirium. There are not echocardiographic predictors of delirium. Echocardiographic parametersWithout delirium(n = 391)With delirium(n = 110)p valueBaseline echocardiographic parametersLeft ventricular ejection fraction (%)57.7 ± 13.457.5 ± 14.10.912Mitral regurgitation (moderate to severe)106 (27.1)34 (30.9)0.433Pulmonary hypertension168 (43.0)53 (49.1)0.258Aortic regurgitation (moderate to severe)74 (18.9)21 (19.1)0.969Peak aortic gradient (mmHg)78.7 ± 25.278.5 ± 23.30.935Mean aortic gradient (mmHg)47.1 ± 16.146.7 ± 14.80.838Aortic valvular area (cm2)0.6 ± 0.20.6 ± 0.20.589Aortic annulus diameter (mm)22.5 ± 2.722.4 ± 2.50.615After TAVI echocardiographic parametersAortic regurgitation (moderate to severe)36 (9.3)11 (10.0)0.813Peak aortic gradient (mmHg)17.6 ± 9.617.7 ± 8.30.916Mean aortic gradient (mmHg)8.9 ± 5.49.3 ± 4.90.481Aortic valvular area (cm2)2.0 ± 0.62.2 ± 0.60.478Values are mean ± standard deviation, or n (%).

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Clinical characteristics and in-hospital outcome of heart failure in women: a single center registry from Egyptian cardiac care unit

The Egyptian Heart Journal ◽

10.1186/s43044-019-0032-0 ◽

2019 ◽

Vol 71 (1) ◽

Cited By ~ 1

Author(s):

Hala Mahfouz Badran ◽

Marwa Ahmed Elgharably ◽

Naglaa Faheem

Keyword(s):

Clinical Characteristics ◽

Heart Diseases ◽

University Hospital ◽

Cardiac Care ◽

Single Center ◽

Term Outcome ◽

Cross Sectional ◽

Valvular Heart Diseases ◽

Significant Difference ◽

Cardiac Care Unit

Abstract Background This study represents figures from a cardiac care unit (CCU) of a university hospital; it describes an example of a tertiary academic center in Egypt and provides an epidemiological view of the female HF patients, their risk profile, and short-term outcome during hospitalization. Results It is a local single-center cross-sectional observational registry of CCU patients 1 year from July 2015 to July 2016. Patient’s data were collected through a special software program. Women with evidence of HF were thoroughly studied. Among the 1006 patients admitted to CCU in 1 year, 345 (34.2%) patients were females and 118 (34.2%) had evidence of HF, whereas 661 (65.7%) were males and 178 (26.9%) of them had HF. Women with HF showed 11.7% prevalence of the total population admitted to CCU. 72.7% were HFrEF and 27.3% were HFpEF. Compared to men, women with HF were older in age, more obese, less symptomatic than men, had higher incidence of associated co-morbidities, less likely to be re-admitted for HF, and less likely to have ACS and PCI. Valvular heart diseases and cardiomyopathies were the commonest etiologies of their HF. Women had more frequent normal ECG, higher EF%, and smaller LA size. There is no difference in medications and CCU procedures. While females had shorter stay, there is no significant difference in hospital mortality compared to male patients. Conclusions Despite higher prevalence of HF in females admitted to CCU and different clinical characteristics and etiology of HF, female gender was associated with similar prognosis during hospital course compared to male gender.

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Acute Myocardial Infarction, Cardiac Arrest, and Cardiac Shock in the Cardiac Care Unit

Physician Assistant Clinics ◽

10.1016/j.cpha.2018.11.004 ◽

2019 ◽

Vol 4 (2) ◽

pp. 333-349

Author(s):

Gabriel Najarro ◽

Kyle Briggs

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiac Arrest ◽

Cardiac Care ◽

Cardiac Shock ◽

Cardiac Care Unit

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Caring touch and anxiety in myocardial infarction patients in the intermediate cardiac care unit

Intensive Care Nursing ◽

10.1016/0266-612x(86)90044-1 ◽

1986 ◽

Vol 2 (2) ◽

pp. 61-66 ◽

Cited By ~ 17

Author(s):

Marilyn S. Glick

Keyword(s):

Myocardial Infarction ◽

Cardiac Care ◽

Cardiac Care Unit

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HUBUNGAN LAMA HARI RAWAT DENGAN TINGKAT KECEMASAN KELUARGA PASIEN DI RUANG INTENSIVE CARDIAC CARE UNIT

Jurnal Persatuan Perawat Nasional Indonesia (JPPNI) ◽

10.32419/jppni.v5i2.212 ◽

2021 ◽

Vol 5 (2) ◽

pp. 74

Author(s):

Nifa Viranda Amelia

Keyword(s):

Intensive Care ◽

Length Of Stay ◽

Average Length ◽

Emotional Reactions ◽

Cardiac Care ◽

Cross Sectional ◽

Purposive Sampling ◽

The Family ◽

Anxiety Levels ◽

Cardiac Care Unit

Selama pasien dirawat di ruang Intensive Cardiac Care Unit (ICCU), keluarga pasien mengalami kesulitan dan ketidakberdayaan. Bagi keluarga pasien, ruang rawat intensif merupakan tempat yang tidak menyenangkan. Keluarga masuk dalam kondisi yang tidak terduga dan dibutuhkan ketepatan keluarga dalam mengambil keputusan guna keberlangsungan hidup terkait kondisi pasien yang membutuhkan penanganan.Lama perawatan pasien di ruang ICCU sangat beragam. Lama rawat pasien ICCU berdampak langsung terhadap kualitas hidup pasien dan keluarga, risiko terjadinya di masa depan, dan besarnya pembiayaan dampak dari perawatan. Selama keluarga mendampingi perawatan pasien di ruang ICCU, keluarga akan mengalami berbagai reaksi emosional seperti kecemasan. Tujuan: Mengetahui hubungan lama hari rawat dengan tingkat kecemasan keluarga pasien di ruang ICCU. Metode: Korelasi dengan pendekatan cross sectional dengan sampel 42 responden di ruang ICCU, yang dipilih dengan menggunakan metode purposive sampling. Instrumen penelitian ini menggunakan kuesioner HARS. Data dianalisis dengan uji korelasi Spearman. Hasil: Lama hari rawat pasien rata-rata 3,14 hari. Kecemasan keluarga pasien ICCU paling banyak berada pada tingkat kecemasan berat (33,3%). Terdapat hubungan yang bermakna antara lama hari rawat dengan tingkat kecemasan keluarga pasien (p=0,0003) dengan keeratan hubungan yang sedang (r=0,532) di ruang ICCU. Diskusi: Semakin lama pasien dirawat di ruang ICCU maka semakin tinggi tingkat kecemasan yang dirasakan keluarga pasien karena kondisi pasien yang tidak stabil ataupun semakin parah. Kesimpulan: Keluarga pasien perlu diberikan informasi dan edukasi yang jelas terkait kondisi pasien dalam sehari atau saat ada perburukan kondisi.Kata kunci: kecemasan, keluarga, lama hari rawat, perawatan intensif, perawatan kritis. Correlation Between Length of Stay and Anxiety Levels of Patients’ Family in Intensive Cardiac Care Unit Room ABSTRACTWhile a patient is being treated in the Intensive Cardiac Care Unit (ICCU), the patient's family experiences difficulties and helplessness. For the patient's family, the intensive care unit is an unpleasant place. The family enters into unexpected conditions and is required to make proper decisions for survival related to patient conditions. The patient's length of stay in the ICCU room is very diverse. The length of stay of ICCU patients directly impacts patients' quality of life and their families, the risk of future incidence, and the extent of the treatment cost. While the family accompanies the patient treated in the ICCU room, the family will experience various emotional reactions such as anxiety. Objective: To reveal the correlation between length of stay and the anxiety levels of the patient’s family in the ICCU room. Methods: Correlation with cross-sectional approach with a sample of 42 respondents in the ICCU room, who were selected using a purposive sampling method. The research instrument used the HARS questionnaire. Data were analyzed using the Spearman correlation test. Results: The average length of the patient's stay was 3.14 days. Family anxiety of ICCU patients was mostly at the level of severe anxiety (33.3%). There was a significant correlation between length of stay and anxiety levels of the patient’s family (p=0.0003) with a moderate correlation coefficient (r=0.532) in the ICCU room. Discussion: The longer the patient is treated in the ICCU room, the higher the anxiety level felt by the patient’s family due to the patient's unstable or worsened condition. Conclusion: Clear information and education should be given to the patient's family regarding the patient's condition within one day or when the condition worsens.Keywords: anxiety, family, length of stay, intensive care, critical care

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