Publications by authors named "Daniel A Gerber"
Article Synopsis
- Previous studies show variability in cardiac intensive care unit (CICU) length of stay (LOS), but lacked detailed risk assessments upon admission, prompting a new evaluation of LOS and its link to in-hospital mortality across different hospitals.
- Analysis of 22,862 admissions from 35 CICUs over five years revealed a median CICU LOS of 2.2 days, with longer stays associated with younger patients having more comorbidities and higher mortality rates across tertiles of LOS.
- The study concluded that significant differences in CICU LOS exist and that longer LOS correlates with increased risk of in-hospital mortality, suggesting improvements in CICU planning and resource use are necessary.
Prognostic significance of haemodynamic parameters in patients with cardiogenic shock.
Eur Heart J Acute Cardiovasc Care
October 2023
Article Synopsis
- Invasive haemodynamic assessment using a pulmonary artery catheter is important for managing patients with cardiogenic shock (CS) and understanding their prognosis.
- A study analyzed data from a multicenter registry involving patients with CS to find relationships between their haemodynamic parameters and outcomes like in-hospital mortality and end-organ dysfunction.
- Key findings indicated that lower mean arterial pressure, lower systolic blood pressure, and other specific haemodynamic metrics were linked to worse outcomes and higher serum lactate levels, suggesting severe circulatory issues.
Background: Cardiac arrest (CA) is a common reason for admission to the cardiac intensive care unit (CICU), though the relative burden of morbidity, mortality, and resource use between admissions with in-hospital (IH) and out-of-hospital (OH) CA is unknown. We compared characteristics, care patterns, and outcomes of admissions to contemporary CICUs after IHCA or OHCA.
Methods: The Critical Care Cardiology Trials Network is a multicenter network of tertiary CICUs in the US and Canada.
Article Synopsis
- Heart failure-related cardiogenic shock (HF-CS) is becoming more common in cardiac intensive care units, and this study focused on whether the chronicity of heart failure affects clinical profiles in these patients.
- Researchers analyzed data from 28 centers involving 1,405 admissions for HF-CS between 2017-2020, finding that 26.3% were classified as de novo HF-CS and 73.7% as acute-on-chronic HF-CS.
- Patients with de novo HF-CS exhibited fewer comorbidities but had more severe shock symptoms and a higher risk of in-hospital mortality compared to those with acute-on-chronic HF-CS, indicating the need for further research on the underlying mechanisms and treatment responses in these
Background: Single-center studies suggest that implementation of multidisciplinary cardiogenic shock (CS) teams is associated with improved CS survival.
Objectives: The aim was to characterize practice patterns and outcomes in the management of CS across multiple centers with versus without shock teams.
Methods: The Critical Care Cardiology Trials Network is a multicenter network of cardiac intensive care units (CICUs) in North America.
Article Synopsis
- Patients admitted to cardiac ICUs are becoming more complex, highlighting the need for studies on their diagnoses and management, particularly concerning respiratory failure.
- In a study involving 8,240 admissions across 25 cardiac ICUs from 2017 to 2019, significant use of advanced respiratory therapies was noted, with 23.5% receiving invasive mechanical ventilation and higher in-hospital mortality rates consequently.
- The data suggested that conditions like heart failure and infections are prevalent among those needing respiratory support, with a concerning mortality increase associated with advanced treatments.
Article Synopsis
- Temporary mechanical circulatory support (MCS) devices are used to help patients with shock that doesn't respond to medication, but previous studies mainly focused on single devices or specific shock causes, limiting understanding of overall practices in cardiac intensive care units (CICUs).* -
- The CCCTN network collected data from 16 CICUs in North America over a year, revealing that 34% of 585 patients with cardiogenic shock or mixed shock received temporary MCS, with significant differences in device usage across centers.* -
- Intraaortic balloon pumps (72%) were the most common device, showing better patient conditions compared to other MCS types, suggesting that while the use of temporary MCS varies widely, patient
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