Association of Cardiopulmonary Hemodynamics and Outcomes in Pulmonary Hypertension Following Kidney Transplantation: A Multicenter Retrospective Cohort Study.

Background: Pulmonary hypertension (PH) frequently complicates the evaluation of kidney transplantation (KT) candidates, and is associated with increased adverse outcomes (mortality, delayed graft function [DGF], and major adverse cardiovascular event) following KT.

Research Question: What is the relationship between cardiopulmonary hemodynamics and post-KT outcomes?

Study Design And Methods: We conducted a multicenter retrospective cohort study of adults undergoing KT between October 1, 2011 and October 1, 2021, who underwent right heart catheterization (RHC) to assess cardiopulmonary hemodynamics within 1 year of transplantation. Frailty models and logistic regression models were used to evaluate the association between cardiopulmonary hemodynamics and outcomes (mortality, DGF, major adverse cardiovascular event) following KT.

Post-intensive care syndrome and COVID-19 - Implications post pandemic.

Post-intensive care syndrome (PICS) describes new or worsening physical, cognitive, or mental impairments in a patient following critical illness or intensive care. The COVID-19 pandemic will likely result in many more patients with PICS and its associated health and economic challenges. Screening and assessment tools done during hospitalization, at discharge, and post discharge should be utilized to facilitate services and strategies to improve PICS outcomes for patient and their families.

Addressing caregiver moral distress during the COVID-19 pandemic.

Moral distress is the psychological distress that is experienced in relation to a morally challenging situation or event. Although it was first observed within nursing, caregivers across all disciplines-including physicians, respiratory therapists, social workers and chaplains-experience moral distress. In this consult, we discuss 5 types of moral distress using examples of changes to clinical practice that have occurred due to COVID-19.

Ethical considerations during the COVID-19 pandemic.

The care of patients during the COVID-19 pandemic has added many layers of complexity to ethical issues. Our response emphasizes the importance of having an ethically sound framework to inform our decisions, requiring caregivers to consider what is ethically optimal and feasible for the patient. It is increasingly important to understand the ethical principles and to appropriately apply them to both patient management decisions and guide scarce resource allocation.

The role of palliative care in COVID-19.

In light of the COVID-19 pandemic, many healthcare systems are experiencing an increased demand for palliative care (PC). To meet this challenge, the PC team at Cleveland Clinic designed an enterprise-wide response plan organized around 4 domains: (educational resources and tools), (medications and supplies), (recommendations for optimizing physical space and facilities), and to facilitate high-quality PC delivery to patients. To mitigate isolation during end-of-life care, the Clinic offers "compassionate exceptions" to strict visitation policies, provides personal protective equipment to visitors of these patients, and facilitates virtual visitation via electronic devices.

Effect of bilateral lung transplantation on excessive dynamic airway collapse.

Introduction: Excessive dynamic airway collapse (EDAC) is associated with significant respiratory morbidity. It has been hypothesized that EDAC may limit the benefits of lung transplantation in chronic obstructive pulmonary disease (COPD) patients. We aim to find the effect of bilateral lung transplantation on EDAC in COPD patients.