Publications by authors named "Cass Sandoval"
Article Synopsis
- QT/QTc prolongation can lead to torsade de pointes, and while 12-lead ECGs are commonly used for assessment, they disrupt patient care; bedside monitors with QT/QTc software have been implemented in the ICU.
- A study assessed the accuracy of QT/QTc measurements from these bedside monitors using four leads compared to standard 12-lead ECGs, involving measurements taken within 30 minutes of each other.
- The results indicated good agreement between the two methods, suggesting that bedside monitor QT/QTc readings could effectively identify at-risk patients without needing as many 12-lead ECGs, though further research is needed with larger and non-ICU patient samples.
Background: In hospitalized patients, QT/QTc (heart rate corrected) prolongation on the electrocardiogram (ECG) increases the risk of torsade de pointes. Manual measurements are time-consuming and often inaccurate. Some bedside monitors automatically and continuously measure QT/QTc; however, the agreement between computerized versus nurse-measured values has not been evaluated.
View Article and Find Full Text PDFBackground: Ventricular tachycardia (V-tach) is the most common lethal arrhythmia, yet 90% of alarms are false and contribute to alarm fatigue. We hypothesize that some true V-tach also causes alarm fatigue because current criteria are too sensitive (i.e.
View Article and Find Full Text PDFBackground: Excessive electrocardiographic alarms contribute to "alarm fatigue," which can lead to patient harm. In a prior study, one-third of audible electrocardiographic alarms were for accelerated ventricular rhythm (AVR), and most of these alarms were false. It is uncertain whether true AVR alarms are clinically relevant.
View Article and Find Full Text PDFBackground: Cheyne-Stokes respiration and periodic breathing (CSRPB) have not been studied sufficiently in the intensive care unit setting (ICU).
Objectives: To determine whether CSRPB is associated with adverse outcomes in ICU patients.
Methods: The ICU group was divided into quartiles by CSRPB (86 patients in quartile 1 had the least CSRPB and 85 patients in quartile 4 had the most CSRPB).
The most common indication for continuous renal replacement therapy (CRRT) in critically ill patients is acute kidney injury with hemodynamic instability. Typically, the patient has metabolic disturbances and potential or actual fluid overload that require intervention. Certain critical care diagnoses and/or conditions or therapies present unique CRRT management approaches.
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