Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure.

Background: Delayed sternal closure (DSC) can be a lifesaving approach for certain patients who have undergone cardiac surgery. The value of the type of prophylactic antibiotics in DSC is still debatable.

Aim: To investigate clinical outcomes of different prophylactic antibiotic regimens in patients who had DSC after cardiac surgery.

QPGx-CARES: Qatar pharmacogenetics clinical applications and research enhancement strategies.

Pharmacogenetic (PGx)-informed medication prescription is a cutting-edge genomic application in contemporary medicine, offering the potential to overcome the conventional "trial-and-error" approach in drug prescription. The ability to use an individual's genetic profile to predict drug responses allows for personalized drug and dosage selection, thereby enhancing the safety and efficacy of treatments. However, despite significant scientific and clinical advancements in PGx, its integration into routine healthcare practices remains limited.

Extracorporeal Membrane Oxygenation Pathway for Management of Refractory Cardiac Arrest: a Retrospective Study From a National Center of Extracorporeal Cardiopulmonary Resuscitation.

Background: Cardiac arrest remains a critical condition with high mortality and catastrophic neurological impact. Extracorporeal cardiopulmonary resuscitation (ECPR) has been introduced as an adjunct in cardiopulmonary resuscitation modalities. However, survival with good neurological outcomes remains a major concern.

Trends in Off-Label Indications of Non-Vitamin K Antagonist Oral Anticoagulants in Acute Coronary Syndrome.

Acute coronary syndrome (ACS) is a leading cause of mortality worldwide. Despite optimal antiplatelet therapy recommendation after ischemic events, recurrent thrombotic complications rate remains high. The recurrent events maybe in part due to increased thrombin levels during ACS which may underscore the need for an additional anticoagulation therapy.

Optimum heparin dose in off-pump coronary artery bypass grafting: A systematic review and meta-analysis.

Introduction: Off-pump coronary artery bypass grafting (OPCABG) was introduced many years ago aiming to reduce the known complications of conventional on-pump coronary surgeries. Heparin is required during the procedures, but the available protocols have diverse dosage regimens. The primary objective of this systematic review is to examine the effect of different heparin doses on the outcomes of OPCABG.

Retrograde Percutaneous Tracheostomy. Early Experience With a Cadaveric Case Report.

Despite the many accomplishments since the introduction of percutaneous dilational (PDT) tracheostomy, we continue to observe emerging complications as we forge ahead in intensive care practice. As a result of this, we provide a new technique that could avoid some complications, notably posterior tracheal wall injury, bronchoscopic or endotracheal tube puncture, and false track. The new technology was evaluated on a 75-year-old Caucasian male cadaver was selected for a novel PDT technique.

Robotic Coronary Revascularization is Feasible and Safe: 10-year Single-Center Experience.

Objective: The purpose of this study is to investigate the outcomes of patients undergoing robotic surgical coronary revascularization whether total endoscopic coronary artery bypass (TECAB) or robotic-assisted minimally invasive direct coronary artery bypass (RA-MIDCAB) in our center.

Methods: This is a retrospective single-center study. It was conducted in the heart hospital at Hamad Medical Corporation, Qatar.

Insight into appropriate medication prescribing for elderly in the COVID-19 era.

Coronavirus disease 2019 (COVID-19) complicates clinical management in elderly population. There is an additional need to properly treat and monitor elderly COVID-19 patients. This paper discusses the inappropriate medication prescribing in the elderly and suggests an updated valid assessment tool considering COVID-19 and its treatment.

Delivery of Acute Rehabilitation to a Postcoronary Artery Bypass Graft COVID-19 Patient in a Pandemic Environment.

During the first wave of the coronavirus disease (COVID-19) pandemic, a 57-year-old COVID-19 male patient was diagnosed with non-ST-elevation myocardial infarction and required urgent coronary artery bypass graft. In-patient cardiac rehabilitation following cardiac surgery was inevitable to limit or prevent various postoperative complications. A routine rehabilitation program was not feasible because of the strict COVID-19 isolation procedures, the high risk of cross infections, and the lack of various resources.

Adding colchicine to tocilizumab in hospitalized patients with severe COVID-19 pneumonia: An open-label randomized controlled trial.

Introduction: Colchicine acts upstream in the cytokines cascade by inhibiting the nod-like receptor protein 3 (NLRP3) inflammasome while interleukin 6 (IL-6) receptor antagonists, such as tocilizumab, block the end result of the cytokines cascade. Hence, adding colchicine to tocilizumab with the aim of blocking the early and end products of the cytokines cascade, might reduce the risk of developing cytokine storm.

Methods And Analysis: We aim to conduct an open-label randomized controlled trial to evaluate the efficacy and safety of adding colchicine to tocilizumab among patients with severe COVID-19 pneumonia to reduce the rate of invasive mechanical ventilation and mortality.

Impact of Extracorporeal Membrane Oxygenation Service on Burnout Development in Eight Intensive Care Units. A National Cross-Sectional Study.

Objectives: This study aimed at investigating the effects of an extracorporeal membrane oxygenation (ECMO) service on Burnout syndrome (BOS) development in the intensive care unit (ICU).

Design: The authors conducted a cross-sectional descriptive study.

Settings: Eight ICUs within 5 tertiary hospitals in 1 country.

Burnout among Respiratory Therapists and Perception of Leadership: A Cross Sectional Survey Over Eight Intensive Care Units.

Background: Burnout syndrome (BOS) is a job-related stress disorder featured by three main cardinal manifestations: emotional exhaustion (EE), reduced personal accomplishment (PA), and depersonalization (DP).

Aim: We aimed to report the prevalence of burnout and the impact of leadership and work condition on the burnout among respiratory therapists (RT) are front-line practitioners in many critical settings.

Methods: We surveyed RT in eight intensive care units (ICU) at five tertiary hospitals, under one medical corporation, using three instruments: the Maslach Burnout Inventory Human Services Survey for Medical Personnel, Condition of Work Effectiveness Questionnaire (CWEQ), and Leadership behaviours scale.

Could Selective Re-look Angiography Improve the Outcome of Cardiogenic Shock in Patients Under Veno-arterial Extracorporeal Membrane Oxygenator?

It is not well studied whether a secondary look by angiography (Re-Ang) after fixing the culprit lesion would be beneficial or not in cardiogenic shock (CS) supported by veno-arterial extracorporeal membrane oxygenator (VA-ECMO). This study was a retrospective observational one that looked at 5-year data from a single tertiary center. Patients were grouped according to the need of Re-Ang during the VA-ECMO course into 2 groups.

The influence of intra-aortic balloon counter pulsation on central venous blood oxygen saturation.

Objectives: We aim at identifying the changes in venous blood saturation values that associates intra-aortic balloon pump (IABP) in cardiac surgery patients with reduced left ventricular function (LVF).

Methods: A retrospective observational study was conducted in a cardiothoracic intensive care unit (CTICU) in a tertiary cardiac center over 5 years in Qatar. A total of 114 patients with at least moderate impairment of LVF with ejection fraction (EF) less than 40% were enrolled.

Successful Use of Intravenous B-blocker Therapy in Cardiogenic Shock Supported With Venoarterial Extracorporeal Membrane Oxygenation: A Case Series.

Tachycardia in cardiogenic shock (CS) might reduce the cardiac output (CO) by decreasing the ventricular filling time. Nevertheless, heart rate (HR) control with agents that possess negative inotropy might decrease the CO. Therefore, controlling the tachycardia in the setting of CS remains controversial.

Impact of COVID-19 pandemic on liver, liver diseases, and liver transplantation programs in intensive care units.

Emerging worldwide data have been suggesting that coronavirus disease 2019 (COVID-19) pandemic consequences are not limited to the respiratory and cardiovascular systems but encompass adverse gastrointestinal manifestations including acute liver injury as well. Severe cases of liver injury associated with higher fatality rates were observed in critically ill patients with COVID-19. Intensive care units (ICU) have been the center of disposition of severe cases of COVID-19.

Association of ruptured sinus of Valsalva aneurysm and congenital ventricular septal defect: a case series.

Background: Ruptured sinus of Valsalva aneurysm (RSOVA) is rare, and it is more common in Asians. Typically, the patient presents with acute/subacute shortness of breath (SOB) and chest pain. Echocardiography is the gold standard for diagnosis in most of these cases.

Multidisciplinary, early mobility approach to enhance functional independence in patients admitted to a cardiothoracic intensive care unit: a quality improvement programme.

Early mobilisation following cardiac surgery is vital for improved patient outcomes, as it has a positive effect on a patient's physical and psychological recovery following surgery. We observed that patients admitted to the cardiothoracic intensive care unit (CTICU) following cardiac surgery had only bed exercises and were confined to bed until the chest tubes were removed, which may have delayed patients achieving functional independence. Therefore, the CTICU team implemented a quality improvement (QI) project aimed at the early mobilisation of patients after cardiac surgery.

Chest radiography requirements for patients with asymptomatic COVID-19 undergoing coronary artery bypass surgery: Three case reports.

Background: The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2, represents a major challenge to health care systems both globally and regionally, with many opting by cancelling elective surgeries. Cardiac operations in patients diagnosed with COVID-19 have been imperative due to their emergency nature, critical condition of patients awaiting cardiac surgery, and accumulated number of cardiac surgical interventions throughout the last months.

Case Summary: Here we describe three COVID-19 positive cases who underwent coronary surgery, on an urgent basis.

Intermittent levosimendan infusion in ambulatory patients with end-stage heart failure: a systematic review and meta-analysis of 984 patients.

We sought to synthesize the available evidence regarding safety and efficacy of intermittent levosimendan (LEVO) infusions in ambulatory patients with end-stage heart failure (HF). Safety and efficacy of ambulatory intermittent LEVO infusion in patients with end-stage HF are yet not established. We systematically searched MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane databases, from inception to January 30, 2021 for studies reporting outcome of adult ambulatory patients with end-stage HF treated with intermittent LEVO infusion.