Critical Connections
December 2006
This Issue's Focus: Cardiac
Recent Advances in Cardiology Pharmacotherapies for the ICU Clinican
Thrombolytics in Pulmonary Embolism: Risk Stratification and Timing
Pharmaconutrition: A New Emerging Paradigm
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Recent Advances in Cardiology for the ICU Clinician
Joseph F. Dasta, MSc, FCCM
The Ohio State University
College of Pharmacy
Columbus, Ohio, USA
Jaclyn M. LeBlanc, PharmD, BCPS
The University of Oklahoma
College of Pharmacy-Tulsa
Tulsa, Oklahoma, USA
No disclosures to report.
1. Ng T, Singh AK, Dasta J, Feldman D, Mebaaza A. Contemporary issues in the pharmacologic management of acute heart failure. Crit Care Clin. 2006;22:199-219.
2. Munger M. Management of acute heart failure: treatment, controversy, and future directions. Pharmacotherapy. 2006;26(8 pt 2):131S-138S.
3. Dasta J, Durtschi A, McLaughlin T, Padley R, Feldman D. The development of a database of patients admitted with primary and secondary heart failure from 2.5 million admissions: patient characteristics and outcomes. J Cardiac Fail. 2005;11:S167
4. Gibson C, Morrow D, Murphy S, et al. A randomized trial to evaluate the relative protection against post-percutaneous coronary intervention microvascular dysfunction, ischemia, and inflammation among antiplatelet and antithrombotic agents. J Am Coll Cardiol. 2006;47:2364-2373.
5. Stone GW, McLaurin BT, Cox DA, et al. Bivalirudin for patients with acute coronary syndromes. N Engl J Med 2006;355:2203-2216
6. Zerumsky K, Seybert AL, Saul MI, Lee JS, Kane-Gill SL. Evaluation of clinical outcomes of anticoagulation during percutaneous coronary intervention. Pharmacotherapy. 2005;25:1434.
7. Cannon CP, Steinberg BA, Murphy SA, Mega JL, Braunwald E. Meta-analysis of cardiovascular outcomes trials comparing intensive versus moderate statin therapy. J Am Coll Cardiol. 2006;48:438-445.
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Thrombolytics in Pulmonary Embolism: Risk Stratification and Timing
Andrew Stone, MD
Providence VA Medical Center
Providence, Rhode Island, USA
Chee Chan, MD
Brown University
Rhode Island Hospital
Providence, Rhode Island, USA
No disclosures to report.
1. Douketis JD, Kearon C, et al. “Risk of fatal pulmonary embolism in patients with treated venous thromboembolism.” JAMA. 1998; 279:458-462.
2. Konstantinides S, Geibel A, et al. “Heparin plus Alteplase Compared with Heparin Alone in Patients with Submassive Pulmonary Embolism.” N Engl J Med 2002; 347:1143-1150.
3. Schoepf, UJ, Kucher N, et al. “Right ventricular enlargement on chest computed tomography: a predictor of early death in acute pulmonary embolism.” Circulation. 2004; 110:3276-3280.
4. Geibel A, Zehender M, et al. “Prognostic value of the ECG on admission in patients with acute major pulmonary embolism.” Eur Respir J 2005; 25:843-848.
5. Van der Meer RW, Pattynama PM, et al. “Right ventricular dysfunction and pulmonary obstruction index at helical CT: prediction of clinical outcome during 3 month follow up in patients with acute pulmonary embolism.” Radiology 2005; 235:798-803.
6. Kucher N, Goldhaber SZ. “Cardiac biomarkers for risk stratification of patients with acute pulmonary embolism.” Circulation 2003; 108:2191-2194.
7. Douketis JD, Leeuwenkamp O, et al. “The incidence and prognostic significance of elevated cardiac troponins in patients with submassive pulmonary embolism.” J Thromb Haemost 2005; 3:508-513.
8. Kostrubiec M, Pruszczyk P, et al. “Biomarker-based risk assessment model in acute pulmonary embolism.” Eur Heart J 2005. [Epub ahead of print].
9. Binder L, Pieske B, et al. “N-terminal pro-BNP testing combinved with echocardiography for risk stratification of acute pulmonary embolism.” Circulation 2005; 112:1573-1579.
10. Belenkie I, Dani R, et al. “Ventricular Interaction During Experimental Acute Pulmonary Embolism.” Circulation 1988; 78:761-768.
11. Belenkie I, Dani R, et al. “Effects of Volume Loading During Experimental Acute Pulmonary Embolism.” Circulation 1989; 80:178-188.
12. Kucher N, Rossi E, et al. “Massive Pulmonary Embolism.” Circulation 2006; 113:577-582.
13. Gibson N, Sohne M, et al. “Prognostic Value of Echocardiography and Spiral Computed Tomogrphy in Patients with Pulmonary Embolism.” Current Opinion in Pulmonary Medicine 2005; 11:380-384.
14. Konstantinides S. “Pulmonary Embolism: Impact of Right Ventricular Dysfunction.” Current Opinion in Cardiology 2005; 20:496-501.
15. Goldhaber SZ. “Thrombolytic Therapy for Patients with Pulmonary Embolism who are Hemodynamically Stable but Have Right Ventricular Dysfunction.” Arch Intern Med 2005; 165:2197-2203.
16. Binder L, burkert P, et al. “N-Terminal Pro-Brain Natriuretic Peptide or Troponin Testing Followed by Echocardiography for Risk Stratification of Acute Pulmonary Embolism.” Circulation 2005; 112:1573-1579.
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Pharmaconutrition: A New Emerging Paradigm
Daren K. Heyland, MD
Kingston General Hospital
Kingston, Ontario, Canada
No disclosures to report.
1. Kieft H, Roos AN, Van Drunen J, Bindels A, Bindels JG, Hofman Z. Clinical outcome of immunonutrition in a heterogeneous intensive care population. Intensive Care Med. 2005;31:524-532. http://www.criticalcarenutrition.com. Refer to Website for most current data. Accessed August 1, 2006.
2. Keh D, Boehnke T, Weber-Cartens S, et al. Immunologic and hemodynamic effects of "low-dose" hydrocortisone in septic shock: a double-blind, randomized, placebo-controlled, crossover study. Am J Respir Crit Care Med. 2003;167:512-520.
3. Bernard GR, Vincent JL, Laterre P, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med. 2001;344:699-709.
4. Tschaikowsky K, Hedwig-Geissing M, Schiele A, Bremer F, Schywalsky M, Schuttler J. Coincidence of pro- and anti-inflammatory responses in the early phase of severe sepsis: longitudinal study of mononuclear histocompatibility leukocyte antigen-DR expression, procalcitonin, C-reactive protein, and changes in T-cell subsets in septic and post-operative patients. Crit Care Med. 2002;30:1015-1013.
5. Heyland DK, Dhaliwal R, Drover JW, Gramlich L, Dodek P, Canadian Critical Care Clinical Practice Guidelines Committee. Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients. JPEN J Parenter Enteral Nutr. 2003;27:355-373. Current version available at http://www.criticalcarenutrition.com.
6. Novak F, Heyland DK, Avenell A, Drover JW, Su X. Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med. 2002;30:2022-2029.
7. Heyland DK, Dhaliwal R, Suchner U, Berger MM. Antioxidant nutrients: a systematic review of trace elements and vitamins in the critically ill patient. Intensive Care Med. 2005;31:327-333.
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