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Degefu N, Jambo A, Demissie Regassa L, Getachew M. In-hospital outcome and its predictors among patients with acute cardiogenic pulmonary oedema at a tertiary hospital in Harar, Eastern Ethiopia: a retrospective cohort study. J Pharm Policy Pract 2024; 17:2309294. [PMID: 38405032 PMCID: PMC10885763 DOI: 10.1080/20523211.2024.2309294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Background Acute cardiogenic pulmonary oedema is highly associated with poor in-hospital outcomes. This study aimed to determine the in-hospital outcome and its predictors among patients with acute cardiogenic pulmonary oedema at a tertiary hospital in Harar, Eastern Ethiopia, from May 1 to 20, 2023. Methods A retrospective cohort study was employed among 204 patients with acute cardiogenic pulmonary oedema who were admitted between 1st May 2018 and 30th April 2023. The collected data were entered into Excel, and analysed using theSTATA software version 17. The hazard ratio with its 95% confidence interval was used and a P-value < 0.05 was considered a statistically significant association. Results The overall mortality rate was 17.60 (95% CI: 11.59-26.72) per 1000 person-day observation with mean (±SD) time to death was 2.88 (±2.06) days. Age (AHR: 1.35; 95% CI: 1.04-1.74 for every 10 years), being smoker (AHR: 3.26; 95% CI: 1.05-10.10), having respiratory rate of ≥40 breaths per minute (AHR: 5.46; 95% CI: 1.71-17.45), and having anaemia (AHR: 4.35; 95% CI: 1.23-15.33) were significant predictors of in-hospital mortality. Conclusion More than one in ten patients in this study died in the hospital. Therefore, special attention needs to be considered for patients with those predictors of in-hospital mortality.
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Affiliation(s)
- Natanim Degefu
- Department of Pharmaceutics, School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Abera Jambo
- Department of Clinical Pharmacy, School of Pharmacy, Haramaya University, Harar, Ethiopia
| | - Lemma Demissie Regassa
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Melaku Getachew
- Department of Emergency and Critical Care Medicine, School of Pharmacy, Haramaya University, Harar, Ethiopia
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Youn SH, Shin YC, Yoon J, Baek S, Kim Y. Trauma-induced capillary leak syndrome after penetrating chest injury: Manifestation of massive ascites and pulmonary secretions aggravated by transfusion. ULUS TRAVMA ACIL CER 2022; 28:863-866. [PMID: 35652873 PMCID: PMC10443023 DOI: 10.14744/tjtes.2020.46026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/30/2020] [Indexed: 11/20/2022]
Abstract
Trauma with prolonged shock can cause systemic capillary leak syndrome regardless of the site of injury and a transfusion can aggravate it. The systemic capillary leak induces both an abdominal compartment syndrome and pulmonary edema, and a transfusion can aggra-vate these sequelae within hours. In our case, 21-year-old man with a penetrating injury in his left thorax experienced delay in rescue and definitive surgery. To manage life-threatening shock, massive blood transfusion and crystalloids had been infused. Cardiopulmonary cerebral resuscitations were performed 2 times during the surgery. Massive amount of pulmonary secretions emitted from his airways with severe hypoxia along with development of massive ascites causing abdominal compartment syndrome, while the surgery was underway. After temporary abdominal closure, he was moved to the intensive care unit and underwent venovenous extracorporeal membranous oxygenation. He recovered without any notable complications. It is important to prevent and correct the shock rapidly by appropriate rescue, controlling the source and infusing less amount of crystalloid and transfusion.
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Affiliation(s)
- Seok Hwa Youn
- Department of Surgery, National Medical Center, Seoul-Korea
| | - Yong Chul Shin
- Department of Thoracic Surgery, National Medical Center, Seoul-Korea
| | - Jiho Yoon
- Department of Surgery, National Medical Center, Seoul-Korea
| | - Sunyoung Baek
- Department of Surgery, National Medical Center, Seoul-Korea
| | - Younghwan Kim
- Department of Surgery, National Medical Center, Seoul-Korea
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A new and simple parameter for diagnosis pulmonary edema: Expiratory air humidity. Heart Lung 2022; 52:165-169. [DOI: 10.1016/j.hrtlng.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/20/2021] [Accepted: 01/17/2022] [Indexed: 11/22/2022]
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Carrillo-Alemán L, López-Martínez A, Carrillo-Alcaraz A, Guia M, Renedo-Villarroya A, Alonso-Fernández N, Martínez-Pérez V, Sánchez-Nieto JM, Esquinas-Rodríguez A, Pascual-Figal D. Evolución de los pacientes con insuficiencia cardiaca aguda secundaria a infarto agudo de miocardio tratados con ventilación mecánica no invasiva. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Carrillo-Alemán L, López-Martínez A, Carrillo-Alcaraz A, Guia M, Renedo-Villarroya A, Alonso-Fernández N, Martínez-Pérez V, Sánchez-Nieto JM, Esquinas-Rodríguez A, Pascual-Figal D. Outcome of patients with acute heart failure secondary to acute myocardial infarction treated with noninvasive mechanical ventilation. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:50-59. [PMID: 33257215 DOI: 10.1016/j.rec.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/08/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION AND OBJECTIVES Noninvasive ventilation (NIV) has been shown to reduce the rate of endotracheal intubation and mortality in patients with acute heart failure (AHF). However, patients with AHF secondary to acute coronary syndrome/acute myocardial infarction (ACS-AMI) have been excluded from many clinical trials. The purpose of this study was to compare the effectiveness of NIV between patients with AHF triggered by ACS-AMI and by other etiologies. METHODS Prospective cohort study of all patients with AHF treated with NIV admitted to the intensive care unit for a period of 20 years. Patients were divided according to whether they had ACS-AMI as the cause of the AHF episode. NIV failure was defined as the need for endotracheal intubation or death. RESULTS A total of 1009 patients were analyzed, 403 (40%) showed ACS-AMI and 606 (60%) other etiologies. NIV failure occurred in 61 (15.1%) in the ACS-AMI group and in 64 (10.6%) in the other group (P=.031), without differences in in-hospital mortality (16.6% and 14.9%, respectively; P=.478). CONCLUSIONS The presence of ACS-AMI as the triggering cause of AHF did not influence patients with acute respiratory failure requiring noninvasive respiratory support.
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Affiliation(s)
- Luna Carrillo-Alemán
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Antonia López-Martínez
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Andrés Carrillo-Alcaraz
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Miguel Guia
- Serviço de Pneumologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Lisbon, Portugal.
| | - Ana Renedo-Villarroya
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Nuria Alonso-Fernández
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Víctor Martínez-Pérez
- Departamento de Psicología Básica y Metodología, Universidad de Murcia, Murcia, Spain
| | | | | | - Domingo Pascual-Figal
- Departamento de Cardiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain
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Cheong Y, Kim N, Kim M, Son HJ, Huh J, Kang SS, Lim SY, Hwang B. Postoperative pulmonary edema following vitrectomy in patients with ischemic heart disease and diastolic dysfunction in the post-anesthetic care unit: Two case reports. Medicine (Baltimore) 2020; 99:e22296. [PMID: 32957388 PMCID: PMC7505381 DOI: 10.1097/md.0000000000022296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
RATIONALE The increasing incidence of cardiac comorbidities in the elderly population has led to an increasing demand for vigilance of cardiac dysfunction induced by surgery. Favorable outcomes can be ensured in such cases by an increased awareness of cardiogenic complications, early identification of the problem, and appropriate treatment. PATIENT CONCERNS This study presents 2 cases of acute pulmonary edema (PE) that were likely caused by ischemic heart disease and diastolic dysfunction in postoperative patients, following vitrectomy, in the post-anesthetic care unit. DIAGNOSES Chest x-ray and computed tomography indicated PE. INTERVENTIONS Following the diagnosis of PE, patients were intubated and transferred to the intensive care unit where 20 mg furosemide was injected and 10 μg/kg/min dobutamine was infused intravenously. OUTCOMES On postoperative day 2, the patients' vital signs were stable and there were no signs of respiratory disturbance. LESSONS Physicians should be alert to the potential development of PE as a postoperative complication in patients with left ventricular (LV) diastolic dysfunction and ischemic heart disease, even if the patient has undergone a procedure with mild hemodynamic change and minimal surgical stimulation such as vitrectomy. We propose that physicians treating elderly patients with LV diastolic dysfunction and ischemic heart disease undergoing vitrectomy should consider the use of intraoperative transthoracic echocardiogram or transesophageal echocardiogram with continuous monitoring of blood pressure, using devices such as arterial catheter devices.
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Affiliation(s)
- Yuseon Cheong
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University
| | - Namyoong Kim
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University
| | - Minsoo Kim
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University
| | - Hee-Jeong Son
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University
| | - Jin Huh
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University
| | - Seong-Sik Kang
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University
| | - So Young Lim
- Department of Anesthesiology and Pain Medicine, College of Medicine, Hallym University, Chuncheon Sacred Heart Hospital, Chuncheon, Republic of Korea
| | - Byeongmun Hwang
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University
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Strom JB, Zhao Y, Shen C, Chung M, Pinto DS, Popma JJ, Yeh RW. National trends, predictors of use, and in-hospital outcomes in mechanical circulatory support for cardiogenic shock. EUROINTERVENTION 2018; 13:e2152-e2159. [DOI: 10.4244/eij-d-17-00947] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ahmad S, Chugh A, Rawat A, Dhar M. Comparative analysis of acute coronary syndrome in the elderly and the young: A hospital-based observational study. JOURNAL OF CLINICAL AND PREVENTIVE CARDIOLOGY 2018. [DOI: 10.4103/jcpc.jcpc_4_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Imanishi J, Kaihotsu K, Yoshikawa S, Nishimori M, Sone N, Honjo T, Iwahashi M. Acute pulmonary edema in patients with reduced left ventricular ejection fraction is associated with concentric left ventricular geometry. Int J Cardiovasc Imaging 2017; 34:185-192. [PMID: 28770454 DOI: 10.1007/s10554-017-1218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/22/2017] [Indexed: 10/19/2022]
Abstract
Although acute pulmonary edema (APE) is common in patients with heart failure (HF) with preserved ejection fraction (EF), its pathogenesis in patients with HF with reduced EF (HFrEF) is not completely understood. The purpose of our study was to explore the contributions of left ventricular (LV) geometry to understand the difference between HFrEF patients with or without APE. We studied 122 consecutive acute decompensated HF patients with HFrEF (≤40%). APE was defined as acute-onset dyspnea and radiographic alveolar edema requiring immediate airway intervention. LV geometry was determined from a combination of the LV mass index and relative wall thickness (RWT). Long-term unfavorable outcome events were tracked during a follow-up of a median of 21 months (interquartile range, 10-28 months), during which APE was observed in 29 patients (24%). Compared to those without APE, hospitalized patients with APE had a higher systolic blood pressure, RWT, and LVEF and lower end-diastolic dimension. Among echocardiographic variables, a multivariate logistic regression analysis identified RWT as the only independent determinant of APE (hazard ratio: 2.46, p < 0.001). Those with concentric geometry (n = 25; RWT > 0.42) had a higher incidence of APE relative to those with non-concentric geometry. Furthermore, among patients with APE, mortality was significantly higher among those with concentric geometry (log-rank, p = 0.008). Compared with non-concentric geometry, concentric geometry (increased RWT, not LV mass) was strongly associated with APE onset and a poorer outcome among APE patients. An easily obtained echocardiographic RWT index may facilitate the risk stratification of patients.
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Affiliation(s)
- Junichi Imanishi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shinko Hospital, 1-4-47, Wakihama-cho, Chuo-ku, Kobe, 650-0072, Japan.
| | - Kenji Kaihotsu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shinko Hospital, 1-4-47, Wakihama-cho, Chuo-ku, Kobe, 650-0072, Japan
| | - Sachiko Yoshikawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shinko Hospital, 1-4-47, Wakihama-cho, Chuo-ku, Kobe, 650-0072, Japan
| | - Makoto Nishimori
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shinko Hospital, 1-4-47, Wakihama-cho, Chuo-ku, Kobe, 650-0072, Japan
| | - Naohiko Sone
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shinko Hospital, 1-4-47, Wakihama-cho, Chuo-ku, Kobe, 650-0072, Japan
| | - Tomoyuki Honjo
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shinko Hospital, 1-4-47, Wakihama-cho, Chuo-ku, Kobe, 650-0072, Japan
| | - Masanori Iwahashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Shinko Hospital, 1-4-47, Wakihama-cho, Chuo-ku, Kobe, 650-0072, Japan
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