Publications by authors named "Hubert Hymczak"
Hypothermic cardiac arrest: prognostic factors for successful resuscitation before rewarming.
Scand J Trauma Resusc Emerg Med
November 2024
Objective: To indicate factors predicting return of spontaneous circulation in patients with hypothermic cardiac arrest in the pre-rewarming period.
Methods: A multicenter retrospective study was conducted. We included patients who had suffered cardiac arrest caused by severe accidental hypothermia with a core body temperature of ≤ 28 °C.
Aim Of The Study: Predictive factors for poor outcomes in hypothermic cardiac arrest (HCA) differ from those in normothermic out-of-hospital cardiac arrest (OHCA). This study aimed to evaluate the outcomes of extracorporeal life support (ECLS) in HCA patients who may not be considered eligible based on the guidelines set by the Extracorporeal Life Support Organization (ELSO).
Methods: A retrospective multicentre study included 127 HCA patients, divided into two groups: those meeting the ELSO eligibility criteria for ECLS, and those with at least one of the following ELSO exclusion criteria: age over 70 years, unwitnessed cardiac arrest, or asystole.
Article Synopsis
- Prehabilitation is underutilized in cardiac surgery centers, but the Pre Surgery Check Team study aimed to assess its impact on postoperative pulmonary complications.
- A study involving 725 adult patients showed that a comprehensive prehabilitation program significantly reduced postoperative complications, including pneumonia and surgical site infections.
- The findings suggest that prehabilitation can effectively lower the risk of complications after elective cardiac surgery by providing patients with essential preoperative support and assessments.
Article Synopsis
- The study investigates elderly patients (over 80 years old) in Polish ICUs, aiming to understand their clinical features and outcomes.
- Researchers collected data from 371 patients, comparing frail (CFS > 4) to non-frail patients and assessing mortality rates.
- Findings indicate higher ICU and 30-day mortality in frail patients, with clinical frailty scale (CFS) and SOFA score being significant predictors of ICU mortality.
Introduction: The main purpose of the study was to assess the impact of preoperative interdisciplinary assessment by the PreScheck Team on optimization of the final selection for elective cardiac surgery.
Material And Methods: This is a single-centre prospective observational study. The examined population consisted of 933 adult patients planned for cardiac surgery.
Background: Donor organ shortages cause increasing demand for mechanical circulatory support in patients with end-stage heart failure not only as a bridge to heart transplantation but mainly as a destination therapy. Improved results and increased applicability and durability of left ventricular assist devices (LVADs) have established this treatment option as an alternative to heart transplantation in selected patients. One of the most common complications after LVAD implantation is driveline infections (DLIs).
View Article and Find Full Text PDFBackground: Heart transplantation is the treatment of choice for selected patients with end-stage heart failure. Persistent donor organ shortage causes a growing demand for mechanical circulatory support not only as a bridge to transplantation but mainly as a destination therapy (DT).
Methods: The aim of the study was to analyze the indications, comorbidities, and complications during the follow-up of all patients undergoing left ventricular assist device (LVAD) implantation with at least 12 months of follow-up time in one of the most experienced clinics in Poland between 2015 and 2023.
Study Objective: To indicate predictors of witnessed hypothermic cardiac arrest.
Methods: We conducted a retrospective analysis of 182 patients with severe accidental hypothermia (i.e.
Article Synopsis
- * Extracorporeal life support (ECLS) rewarming is the recommended first-line treatment for these patients, focusing on quickly restoring body temperature and ensuring proper organ blood flow.
- * Veno-arterial extracorporeal membrane oxygenation (ECMO) is a preferred method of ECLS, known for its efficiency but requires skilled medical staff due to its invasive nature and associated risks.
Article Synopsis
- A study was conducted to evaluate if the tendency to limit life-sustaining treatment (LST) among elderly patients in Poland increased from 2016-2017 to 2018-2019.
- The research involved analyzing data from two cohorts of critically ill patients aged over 80, finding that the prevalence of LST limitations rose from 16.1% to 20.5% over the years.
- Although the increase wasn't statistically significant in basic analyses, further investigation showed a stronger inclination to limit LST in the later cohort, along with higher mortality and longer hospital stays for patients with LST limitations.
Article Synopsis
- Treatment options for rewarming severely hypothermic patients with good circulation are not strongly supported by clinical trials, prompting a study comparing extracorporeal and less-invasive rewarming methods.
- A multicenter retrospective study used data from various hypothermia registries to analyze outcomes in patients with core temperatures below 28°C.
- Results showed that extracorporeal rewarming led to a higher survival rate compared to less-invasive methods, with key factors influencing survival including age, cooling circumstances, and absence of comorbidities.
Background: Heart transplantation is the treatment of choice for selected patients with end-stage heart failure. Persistent donor organ shortage has resulted in a growing interest in mechanical circulatory support not only as a bridge to transplantation but also as a destination therapy.
Methods: The aim of the study was to analyze the indications, comorbidities, operative technique, complications, and follow-up of all patients undergoing left ventricular assist device implantation in one of the most experienced clinics in Poland between 2015 and 2020 and state the best timing of the procedure.
Background: Postoperative myocardial infraction (MI) is a serious complication among patients undergoing Coronary Artery Bypass Grafting (CABG). Data on the impact of postoperative MI on patients undergoing CABG, specifically with respect to their long term outcomes are sparse.
Methods: We retrospectively analyzed all patients who underwent isolated CABG between January 2014 and December 2016 and identified those who fulfilled the definition of the type 5MI following CABG according to the Fourth Universal Definition of Myocardial Infarction.
Core Temperature Measurement-Principles of Correct Measurement, Problems, and Complications.
Int J Environ Res Public Health
October 2021
Article Synopsis
- - Core temperature indicates the temperature of internal organs, which is crucial for diagnosing and treating temperature-related issues in patients.
- - Current methods for measuring core temperature vary in accuracy, leading to ongoing discussions about the best anatomical site for measurement.
- - While pulmonary artery catheter measurements are considered the gold standard, esophageal temperature assessment is also seen as a practical alternative in clinical practice.
Background: Primary graft dysfunction (PGD) is the main cause of death in the first 30 days after heart transplantation (HTX), accounting for approximately 40% of mortality. The study's primary aim was to assess the incidence of PGD, following the International Society for Heart and Lung Transplantation consensus, and to compare it with the incidence of significant postoperative hypotension despite administration of high-dose inotropes and vasoconstrictors. The secondary aim of the study was to determine changes in biochemical markers that accompany the phenomenon.
View Article and Find Full Text PDFPrognosis of Hypothermic Patients Undergoing ECLS Rewarming-Do Alterations in Biochemical Parameters Matter?
Int J Environ Res Public Health
September 2021
Article Synopsis
- - This study focused on finding indicators of clinical outcomes for patients undergoing Extracorporeal Life Support (ECLS) rewarming after severe hypothermia, aiming to improve prognosis identification.
- - Conducted at a Polish hospital, the research analyzed data from 50 patients (72% in cardiac arrest) and tracked their acid-base balance and lactate levels at various stages of rewarming.
- - Findings showed that lower lactate levels in survivors compared to non-survivors indicated a better prognosis, suggesting that high lactate concentrations during rewarming correlate with increased mortality risk.
Article Synopsis
- The study aims to evaluate how cardiac arrest during initial treatment affects the survival outcomes of severely hypothermic patients undergoing rewarming with Extracorporeal Life Support (ECLS).
- Researchers analyzed data from 124 severe hypothermia patients, dividing them into two groups: those who experienced a cardiac arrest (RC group) and those who maintained spontaneous circulation (HT3 group), finding a significant difference in mortality rates (24% in HT3 vs. 49% in RC).
- The results indicate that cardiac arrest doubles the risk of death, emphasizing the need for careful management of procedures that might trigger such events, especially in patients who are conscious.
Article Synopsis
- The study investigates the relationship between acid-base balance disturbances and the occurrence of Clostridium difficile infection (CDI) in patients who underwent cardiac surgery, as CDI is a common complication post-surgery.
- Out of 12,235 patients analyzed, 143 developed CDI, with findings indicating that those patients had altered blood gas levels, including lower pH and higher lactate levels.
- Key risk factors for developing CDI post-surgery included high lactate levels during the procedure, reduced lactate clearance, older age, undergoing emergency surgery, and using non-standard antibiotics.
Background: Clostridioides difficile infection (CDI) is the most common cause of hospital-acquired diarrhea. There is little available data regarding risk factors of CDI for patients who undergo cardiac surgery. The study evaluated the course of CDI in patients after cardiac surgery.
View Article and Find Full Text PDFArticle Synopsis
- Hyperlactatemia, a condition marked by high lactate levels, is common after heart surgery and linked to increased ICU stays and mortality, but its specific effects on heart transplant patients haven't been well studied.
- A study analyzed 46 heart transplant patients to determine if their serum lactate levels in the first 48 hours post-surgery could predict in-hospital mortality, using data from arterial blood gas tests taken every 6 hours.
- The findings revealed that higher lactate levels upon ICU admission (specifically over 7.0 mmol/L) were significant predictors of in-hospital mortality, with an accuracy of 90%.