Publications by authors named "B A Pisani"
Extracorporeal membrane oxygenation is increasingly being used to support patients with hypoxemic respiratory failure and cardiogenic shock. During the COVID-19 pandemic, consensus guidance recommended extracorporeal life support for patients with COVID-19-related cardiopulmonary disease refractory to optimal conventional therapy, prompting a substantial expansion in the use of this support modality. Extracorporeal membrane oxygenation was particularly integral to the bridging of COVID-19 patients to heart or lung transplantation.
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- The study investigates current management practices for patients using temporary mechanical circulatory support (tMCS) devices like intra-aortic balloon pumps and Impella in North American cardiac intensive care units.
- An online survey was conducted, with a response rate of 84% from 37 centers, focusing on hemodynamic monitoring, hemocompatibility, and weaning/removal of the devices.
- Results showed significant variability in how these practices are implemented, indicating a need for standardized guidelines to improve patient outcomes with tMCS.
Background: Associations of early changes in vasoactive support with cardiogenic shock (CS) mortality remain incompletely defined.
Methods: The Critical Care Cardiology Trials Network is a multicenter registry of cardiac intensive care units. Patients admitted with CS (2018-2023) had vasoactive dosing assessed at 4 and 24 hours from cardiac intensive care unit admission and quantified by the vasoactive-inotropic score (VIS).
Article Synopsis
- Limited research exists on the causes of death in patients with cardiogenic shock (CS), prompting a study by the Critical Care Cardiology Trials Network from October 2021 to September 2022.
- Among 1068 cases studied, 337 patients (31.6%) died, and 82.2% of these deaths were attributed to cardiovascular issues, primarily persistent cardiogenic shock.
- Key findings showed that patients with prior cardiac arrest had higher risks of dying from anoxic brain injury or arrhythmia, and those receiving temporary mechanical circulatory support (tMCS) often succumbed to persistent shock.
Interhospital Variation in Admissions Managed With Critical Care Therapies or Invasive Hemodynamic Monitoring in Tertiary Cardiac Intensive Care Units: An Analysis From the Critical Care Cardiology Trials Network Registry.
Circ Cardiovasc Qual Outcomes
January 2024
Article Synopsis
- * A study analyzed data from nearly 18,000 CICU admissions across 34 hospitals to assess the use of CCRx and its association with in-hospital survival, finding disparities in patient acuity and therapy utilization among hospitals.
- * The findings revealed that patients in hospitals with higher CCRx usage tended to have more severe conditions and higher comorbidity rates; however, adjusted mortality rates did not significantly differ based on CCRx levels, implying patient factors primarily influence therapy variations.