Publications by authors named "J Julian Le Grand"

Background: Cardiogenic shock complicating acute myocardial infarction is associated with a high mortality rate. Cardiogenic shock after out-of-hospital cardiac arrest (OHCA) can be due to transient myocardial stunning but also reflect the increasing severity of ongoing heart failure. The Society for Cardiovascular Angiography and Interventions (SCAI) proposed a division of cardiogenic shock into 5 phenotypes, with cardiac arrest being a modifier.

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Background: The Blood Pressure and Oxygenation Targets After out-of-hospital cardiac arrest (BOX) trial found no statistically significant differences in mortality or neurological outcomes with mean arterial blood pressure targets of 63 versus 77 mmHg in patients receiving intensive care post-cardiac arrest. In this study, we aimed to evaluate the effect on 1-year mortality and assess heterogeneity in treatment effects (HTE) using Bayesian statistics.

Methods: We analyzed 1-year all-cause mortality, 1-year neurological outcomes, and plasma neuron-specific enolase (NSE) at 48 hours using Bayesian logistic and linear regressions primarily with weakly informative priors.

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Article Synopsis
  • - This review examines important time-sensitive heart conditions that pose major health challenges in Western countries.
  • - It includes both elective conditions and those needing urgent medical or surgical care, such as acute coronary syndrome and pulmonary embolism.
  • - The goal is to enhance understanding of these conditions, their effects on patient outcomes, and the latest treatment approaches in critical scenarios.
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Background: Oxygen therapy is commonly administered to patients with acute cardiovascular conditions during hospitalisation. Both hypoxaemia and hyperoxia can cause harm, making it essential to maintain oxygen saturation (SpO) within a target range. Traditionally, oxygen administration is manually controlled by nursing staff, guided by intermittent pulse oximetry readings.

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Article Synopsis
  • In managing patients revived from cardiac arrest, a key objective is to ensure enough oxygen delivery (DO) to meet oxygen consumption (VO) needs.
  • The study analyzed two target mean arterial blood pressures (MAP) of 63 mm Hg (MAP63) and 77 mm Hg (MAP77), alongside different arterial oxygen partial pressure (PaO) targets, in comatose patients who suffered out-of-hospital cardiac arrests.
  • Results demonstrated that a MAP of 77 mm Hg increased DO and VO compared to 63 mm Hg, while varying PaO targets didn’t affect DO or VO outcomes.
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