Publications by authors named "Steven M Hollenberg"
Purpose Of Review: To explore the definitions of sepsis-induced cardiomyopathy and how that impacts interpretation of the available data and considerations of long-term prognosis and management.
Recent Findings: The field of sepsis-induced cardiomyopathy has been hampered by lack of consensus about its proper definition, with a great deal of heterogeneity in clinical trial data in both individual studies and meta-analyses and consequent disparity of estimates of incidence, prognosis, and clinical significance. New diagnostic techniques, while potentially shedding light on pathophysiology, have only exacerbated these challenges.
Acute decompensated valvular disease encompasses a group of complex and challenging conditions, which are often the primary reason for admission to the cardiac intensive care unit and can also complicate the management of other primary cardiac disorders. Critically ill patients with valvular disease also present unique diagnostic and management challenges. Historically, medical and percutaneous interventional therapies have been limited and surgery was the only definitive treatment; however, surgical risk can at times be prohibitive.
View Article and Find Full Text PDFArticle Synopsis
- - The rates of illness and death are high for patients experiencing cardiac arrest, as traditional CPR methods don't effectively maintain blood flow.
- - Extracorporeal cardiopulmonary resuscitation (eCPR) using venoarterial extracorporeal membrane oxygenation is suggested as a better way to improve blood circulation during cardiac arrest.
- - This article presents a debate on the benefits and drawbacks of current eCPR research, highlighting uncertainties and proposing ideas for future studies.
Article Synopsis
- * They focused on adult education fundamentals, necessary training for high-quality patient care, and emphasized diversity, equity, and inclusion.
- * The resulting paper serves as a guide for trainees, providing insights on the current state of critical care cardiology and outlining future directions for the field’s growth.
Article Synopsis
- The study aimed to establish clear cutoff points for low, intermediate, and high doses of norepinephrine (noradrenaline), a key vasopressor in intensive care, to better assess patient mortality linked to cardiovascular support.
- Researchers analyzed data from over 8,000 ICU patients in Finland and validated the findings with a larger dataset from the U.S., focusing on the highest norepinephrine doses administered within the first 24 hours.
- The identified dose ranges were low (<0.2 μg/kg/min), intermediate (0.2-0.4 μg/kg/min), and high (>0.4 μg/kg/min), with increasing mortality rates correlating with higher doses, demonstrating a significant relationship between norepine
Objectives: To review a contemporary approach to the management of patients with cardiogenic shock (CS).
Data Sources: We reviewed salient medical literature regarding CS.
Study Selection: We included professional society scientific statements and clinical studies examining outcomes in patients with CS, with a focus on randomized clinical trials.
Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations.
Crit Care Med
May 2023
Article Synopsis
- The guideline aims to create evidence-based recommendations for ICU clinicians treating adults with acute liver failure (ALF) or acute on chronic liver failure (ACLF).
- A panel of 27 experts conducted systematic reviews and categorized their findings into Population, Intervention, Comparison, and Outcomes (PICO) questions to guide clinical practice.
- The resulting 28 recommendations include five strong recommendations and 21 conditional ones, but many are based on low-quality evidence, highlighting areas that need further research.
Executive Summary: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations.
Crit Care Med
May 2023
The COVID-19 pandemic has affected clinicians in many different ways. Clinicians have their own experiences and lessons that they have learned from their work in the pandemic. This article outlines a few lessons learned from the eyes of CHEST Critical Care Editorial Board members, namely practices which will be abandoned, novel practices to be adopted moving forward, and proposed changes to the health care system in general.
View Article and Find Full Text PDFBackground: Little is known regarding the causes of critical illness and determinants of prognosis of patients with heart failure (HF) admitted to the modern cardiac intensive care unit (CICU). We sought to describe the epidemiology and outcomes of patients with HF admitted to the contemporary CICU.
Methods And Results: Retrospective cohort analysis of Mayo Clinic CICU patients admitted with HF from 2007 to 2018 who had left ventricular ejection fraction (LVEF) data.
Background: Patients with post-acute sequela of COVID-19 (PASC) often report symptoms of orthostatic intolerance and autonomic dysfunction. Numerous case reports link postural orthostatic tachycardia syndrome (POTS) to PASC. No prospective analysis has been performed.
View Article and Find Full Text PDFBackground Prevention of cardiovascular disease (CVD) is a public health priority. The combination of physical activity, a healthy diet, and abstaining from tobacco plays an important role in prevention whereas aspects of psychosocial well-being have largely been examined separately with conflicting results. This study evaluated whether the combination of indices of psychosocial well-being was associated with less progression of coronary artery calcium (CAC).
View Article and Find Full Text PDFShock Severity Assessment in Cardiac Intensive Care Unit Patients With Sepsis and Mixed Septic-Cardiogenic Shock.
Mayo Clin Proc Innov Qual Outcomes
February 2022
We sought to validate the Society for Cardiovascular Angiography and Interventions (SCAI) cardiogenic shock classification for mortality risk stratification in patients with sepsis and concomitant cardiovascular disease or mixed septic-cardiogenic shock. We conducted a single-center retropective cohort study of cardiac intensive care unit patients with an admission diagnosis of sepsis. We used clinical, vital sign, and laboratory data during the first 24 hours after admission to assign SCAI shock stage.
View Article and Find Full Text PDFAim: This clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients.
Methods: A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing randomized and nonrandomized trials, observational studies, registries, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, Agency for Healthcare Research and Quality reports, and other relevant databases. Additional relevant studies, published through April 2021, were also considered.
Aim: This clinical practice guideline for the evaluation and diagnosis of chest pain provides recommendations and algorithms for clinicians to assess and diagnose chest pain in adult patients.
Methods: A comprehensive literature search was conducted from November 11, 2017, to May 1, 2020, encompassing randomized and nonrandomized trials, observational studies, registries, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, Agency for Healthcare Research and Quality reports, and other relevant databases. Additional relevant studies, published through April 2021, were also considered.