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Sökning: WFRF:(Nikolaou Nikolaos)

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  • Sandroni, Claudio, et al. (författare)
  • ERC-ESICM guidelines on temperature control after cardiac arrest in adults
  • 2022
  • Ingår i: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 48:3, s. 261-269
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of these guidelines is to provide evidence‑based guidance for temperature control in adults who are comatose after resuscitation from either in-hospital or out-of-hospital cardiac arrest, regardless of the underlying cardiac rhythm. These guidelines replace the recommendations on temperature management after cardiac arrest included in the 2021 post-resuscitation care guidelines co-issued by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). The guideline panel included thirteen international clinical experts who authored the 2021 ERC-ESICM guidelines and two methodologists who participated in the evidence review completed on behalf of the International Liaison Committee on Resuscitation (ILCOR) of whom ERC is a member society. We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach to assess the certainty of evidence and grade recommendations. The panel provided suggestions on guideline implementation and identified priorities for future research. The certainty of evidence ranged from moderate to low. In patients who remain comatose after cardiac arrest, we recommend continuous monitoring of core temperature and actively preventing fever (defined as a temperature > 37.7 °C) for at least 72 h. There was insufficient evidence to recommend for or against temperature control at 32–36 °C or early cooling after cardiac arrest. We recommend not actively rewarming comatose patients with mild hypothermia after return of spontaneous circulation (ROSC) to achieve normothermia. We recommend not using prehospital cooling with rapid infusion of large volumes of cold intravenous fluids immediately after ROSC.
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15.
  • Spargias, Konstantinos, et al. (författare)
  • Transaortic aortic valve replacement using the Edwards Sapien-XT Valve and the Medtronic CoreValve : initial experience
  • 2015
  • Ingår i: Hellenic Journal of Cardiology. - 1109-9666. ; 55:4, s. 288-293
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: Transcatheter aortic valve replacement (TAVR) is now an established treatment for certain patients with severe aortic valve stenosis (AS). However, as the number of patients screened for TAVR increases, many are found to have absolutely no option for peripheral artery access. Transaortic valve replacement (TAoVR) has been proposed as a new alternative route in patients deemed unsuitable for conventional approaches. We present our first series of TAoVR cases using the Edwards Sapien-XT and the Medtronic CoreValve prostheses.METHODS: Twenty-five (25) symptomatic patients (mean age 78 ± 8 years, mean logistic EuroSCORE I 25 ± 11%) with severe AS underwent TAoVR using the Sapien-XT valve (10 patients) or the CoreValve (15 patients).RESULTS: The mean fluoroscopy time was 15.6 ± 4.2 minutes, the mean time in the intensive care unit was 1.9 ± 1.0 days, and the mean hospital stay was 6.4 ± 1.6 days. The mean effective aortic valve area increased (from 0.68 ± 0.15 cm(2) to 1.82 ± 0.34 cm(2), p<0.001) and the mean transvalvular pressure gradient declined (from 48 ± 15 mmHg to 9 ± 5 mmHg, p<0.05) post implantation. The procedural mortality was 0% and the in-hospital mortality was 4% (one death at day 3 due to cardiogenic shock). The mean NYHA functional class improved from 3.2 ± 0.4 to 1.5 ± 0.9 at 30 days.CONCLUSIONS: Our initial experience with the TAoVR approach using both the Edwards Sapien-XT and the Medtronic CoreValve prosthesis demonstrated that it could be performed safely, resulting in substantial acute echocardiographic and early clinical improvement.
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