Frequency and outcomes of transient myocardial ischemia in critically ill adults admitted for noncardiac conditions.

نویسندگان

  • Kathy J Booker
  • Karyn Holm
  • Barbara J Drew
  • Dorothy M Lanuza
  • Frank D Hicks
  • Tim Carrigan
  • Michelle Wright
  • John Moran
چکیده

BACKGROUND Critically ill adults admitted for noncardiac conditions are at risk for acute myocardial ischemia. OBJECTIVES To detect myocardial ischemia and injury in patients admitted for noncardiac conditions and to examine the relationship of myocardial ischemia, injury, and acuity to cardiac events. METHODS Transient myocardial ischemia, acuity, elevations in serum troponin I, and in-hospital cardiac events were examined in 76 consecutive patients. Transient myocardial ischemia, determined by using continuous electrocardiography, was defined as a 1-mm (0.1-mV) change in ST level from baseline to event in 1 or more leads lasting 1 or more minutes. Acuity was determined by scores on Acute Physiology and Chronic Health Evaluation II. RESULTS A total of 37 ischemic events were detected in 8 patients (10.5%); 32 (86%) were ST-segment depressions, and 35 (96%) were silent. Twelve patients (15.8%) had elevated levels of troponin I. Transient myocardial ischemia, elevated troponin I levels, and advanced age were significant predictors of cardiac complications (R2 = 0.387, F = 15.2, P < .001). Acuity correlated only modestly with increased length of stay in the intensive care unit (r = 0.26, P = .02) and elevated troponin I levels (r = 0.25, P = .03). Patients with transient myocardial ischemia had significantly higher rates of elevations in troponin I (P < .001) and cardiac events (P < .001) than did patients without. CONCLUSIONS Transient myocardial ischemia and advanced age are predictors of cardiac events and may indicate patients at risk for cardiac events.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Different aspects of transient ischemic dilation

  Transient ischemic left ventricular dilation (TID) is a marker of severe and extensive coronary artery disease as well as an increased risk of adverse outcomes. The patients with more severe and extensive ischemia, multivessel-type of perfusion abnormality as well as patients with left anterior descending artery (LAD) territory perfusion abnormality have more probab...

متن کامل

Metformin Treatment in Hyperglycemic Critically Ill Patients: Another Challenge on the Control of Adverse Outcomes

New-onset hyperglycemia in patients admitted to intensive care units increases the risk of morbidity and mortality. Insulin resistance is frequently seen in the treatment of stress-induced hyperglycemia. Metformin, an oral anti-hyperglycemic agent, may introduce a new treatment protocol in critically ill patients with insulin-resistance hyperglycemia. Fifty-one non-diabetic traumatized patients...

متن کامل

Potential Role of Exogenous Melatonin Supplement in Delirium Prevention in Critically Ill Patients: A Double-Blind Randomized Pilot Study

Critically ill patients often suffer from disturbance of sleep-wake cycle and consequently delirium development, in intensive care units (ICU). In this study, we aimed to evaluate the effect of exogenous melatonin on delirium development and its related adverse sequelae in the subgroup of medical and surgical ICU patients. We performed a double-blind placebo-controlled randomized pilot study i...

متن کامل

Potential Role of Exogenous Melatonin Supplement in Delirium Prevention in Critically Ill Patients: A Double-Blind Randomized Pilot Study

Critically ill patients often suffer from disturbance of sleep-wake cycle and consequently delirium development, in intensive care units (ICU). In this study, we aimed to evaluate the effect of exogenous melatonin on delirium development and its related adverse sequelae in the subgroup of medical and surgical ICU patients. We performed a double-blind placebo-controlled randomized pilot study i...

متن کامل

Nosocomial Infection in Critically Ill Patient Receiving Stress Ulcer Prophylactic Drugs

     Acidic pH of stomach, which is a normal physiological barrier against bacterial overgrowth, would increase by stress ulcer prophylaxis initiation and may lead to bacterial colonization and play as a source for infection transmission to the respiratory system which results in ventilator related pneumonia in patients admitted to the Intensive Care Units (ICUs). Therefore, finding methods to ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • American journal of critical care : an official publication, American Association of Critical-Care Nurses

دوره 12 6  شماره 

صفحات  -

تاریخ انتشار 2003