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Critical Care in Modern Cardiology
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Critical Care in Modern Cardiology

A special issue of Journal of Cardiovascular Development and Disease (ISSN 2308-3425). This special issue belongs to the section "Cardiovascular Clinical Research".

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 19587

Special Issue Editors

Dr. Sasa Rajsic

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Guest Editor
Department of Anaesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
Interests: critical care; intensive care; ECMO; anaesthesia; emergency medicine; cardiology
Special Issues, Collections and Topics in MDPI journals
Dr. Benedikt Treml

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Guest Editor
Department of Anaesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
Interests: critical care; intensive care; ECMO; anaesthesia; emergency medicine
Special Issues, Collections and Topics in MDPI journals
Dr. Robert Breitkopf

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Guest Editor
Department of Anaesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
Interests: critical care; intensive care; transplantation; anaesthesia; emergency medicine; cardiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The outstanding development of critical care in recent decades has led to improved patient outcomes and reduced mortality. The multidisciplinary care of critically ill patients is an integral part of every modern healthcare system, ensuring improved outcomes, which are guaranteed by the prompt development of diverse diagnostic and therapeutic modalities and supported by the continuous education of health workers. Faster and easier access to care, the early recognition of life-threatening medical conditions and complications, and organized emergency care all contribute to treatment strategy for patients with cardiac pathology. Furthermore, the fast development of technologies and continuous research in the field of critical care in modern cariology requires the wide dissemination of information to clinicians.

This Special Issue on “Critical Care in Modern Cardiology” welcomes the submission of work on the most recent developments and challenges in diagnosis and therapy related to advances in experimental and clinical cardiology, surgery, anesthesia, and intensive care research and practice, addressing innovative therapeutic and diagnostic strategies in the care of cardiac patients. We invite all researchers from relevant disciplines who focus on the care of critically ill patients to submit original articles or reviews in their area of expertise, enhancing the multidisciplinarity of modern health care.

Dr. Sasa Rajsic
Dr. Benedikt Treml
Dr. Robert Breitkopf
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Cardiovascular Development and Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • critical care
  • cardiology
  • resuscitation
  • PCA
  • myocardial infarct
  • acute illness
  • intensive care
  • shock
  • cardiogenic shock
  • ECMO
  • arrhythmias
  • STEMI

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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11 pages, 957 KiB  
Article
Optimizing Postoperative Glucose Management in CABG Patients: Exploring Early Transition to Subcutaneous Insulin
by Hamza Alzghoul, Joel Weimer, Abigail Antigua, Geran Maule, Mohamed F. Ismail, Ward Althunibat, Raju Reddy, Abdul Ahad Khan, Nehan Sher, Robyn Meadows and Akram Khan
J. Cardiovasc. Dev. Dis. 2024, 11(11), 348; https://doi.org/10.3390/jcdd11110348 - 1 Nov 2024
Viewed by 1319
Abstract
Introduction: Tight glycemic control is essential for optimal outcomes after coronary artery bypass graft (CABG) surgery, regardless of pre-operative diabetes status. The ideal timing for transitioning from intravenous (IV) to subcutaneous (SC) insulin remains unclear. This study addresses this knowledge gap by comparing [...] Read more.
Introduction: Tight glycemic control is essential for optimal outcomes after coronary artery bypass graft (CABG) surgery, regardless of pre-operative diabetes status. The ideal timing for transitioning from intravenous (IV) to subcutaneous (SC) insulin remains unclear. This study addresses this knowledge gap by comparing the effects of early transition (postoperative day 1, POD1) versus delayed transition on glycemic control and patient outcomes after CABG surgery. Methods: We analyzed data from a single tertiary medical center focusing on patients receiving insulin during their CABG hospitalization between 1 and 31 October 2022. We divided patients into two groups based on their transition timing: (1) Delayed Transition Group, patients transitioned from IV insulin infusion to SC insulin after POD1; and (2) Early Transition Group, patients transitioned on POD1. The primary outcome was the incidence of euglycemia on POD1. Secondary outcomes included rates of maintaining euglycemia from POD1 until POD10 or hospital discharge, hospital length of stay (LOS), ICU LOS, mean glucose levels, rates of hyperglycemia (blood glucose > 180 mg/dL) and hypoglycemia (blood glucose < 70 mg/dL), and rate of restarting IV insulin. Statistical analysis adjusted for BMI and diabetes diagnosis. Results: A total of 394 patients were enrolled, with 68 patients (17.3%) in the delayed-transition group and 326 patients (82.7%) in the early-transition group. Majority of the patients were males (74%), with an average age of 67 ± 9 years. Mean HbA1C and creatinine levels were comparable between the two groups. Patients in the early-transition group experienced a shorter ICU and hospital length of stay compared to the delayed-transition group, without a higher risk of restarting IV insulin. Conclusions: Early transition from IV insulin drip to SC insulin on POD1 of CABG surgery reduces ICU and hospital LOS without increasing the risk of transitioning back to IV insulin. Full article
(This article belongs to the Special Issue Critical Care in Modern Cardiology)
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13 pages, 789 KiB  
Article
Mortality Predictors and Neurological Outcomes Following Extracorporeal Cardiopulmonary Resuscitation (eCPR): A Single-Center Retrospective Study
by Sasa Rajsic, Helmuth Tauber, Robert Breitkopf, Corinna Velik Salchner, Fabian Mayer, Ulvi Cenk Oezpeker and Benedikt Treml
J. Cardiovasc. Dev. Dis. 2024, 11(9), 272; https://doi.org/10.3390/jcdd11090272 - 2 Sep 2024
Viewed by 1579
Abstract
Background: Extracorporeal cardiopulmonary resuscitation (eCPR) offers cardiorespiratory support to patients experiencing cardiac arrest. However, this technology is not yet considered a standard treatment, and the evidence on eCPR criteria and its association with survival and good neurological outcomes remains scarce. Therefore, we aimed [...] Read more.
Background: Extracorporeal cardiopulmonary resuscitation (eCPR) offers cardiorespiratory support to patients experiencing cardiac arrest. However, this technology is not yet considered a standard treatment, and the evidence on eCPR criteria and its association with survival and good neurological outcomes remains scarce. Therefore, we aimed to investigate the overall mortality and risk factors for mortality. Moreover, we provide a comparison of demographic, clinical, and laboratory characteristics of patients, including neurological outcomes and adverse events during support. Methods: This retrospective analysis included in-hospital and out-of-hospital cardiac arrest patients who received eCPR and were admitted between January 2008 and June 2022 at a tertiary and trauma one-level university hospital in Austria. Results: In total, 90 patients fulfilled inclusion criteria, 41 (46%) patients survived until intensive care unit discharge, and 39 (43%) survived until hospital discharge. The most common cause of cardiac arrest was myocardial infarction (42, 47%), and non-shockable initial rhythm was reported in 50 patients (56%). Of 33 survivors with documented outcomes, 30 had a good recovery as measured with Cerebral Performance Category score, 2 suffered severe disability, and 1 remained in a persistent vegetative state. Finally, multivariate analysis identified asystole as initial rhythm (HR 2.88, p = 0.049), prolonged CPR (HR 1.02, p = 0.043), and CPR on the weekend (HR 2.57, p = 0.032) as factors with a higher risk of mortality. Conclusions: eCPR-related decision-making could be additionally supported by the comprehension of the reported risk factors for mortality and severe disability. Further studies are needed to elucidate the impact of peri-arrest variables on outcomes, aiming to improve patient selection. Full article
(This article belongs to the Special Issue Critical Care in Modern Cardiology)
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12 pages, 626 KiB  
Article
Invasive Mechanical Ventilation Is Associated with Worse Right Ventricular Strain in Acute Respiratory Failure Patients
by Shuyuan Wang, Zubair Bashir, Edward W. Chen, Vishnu Kadiyala, Charles F. Sherrod, Phinnara Has, Christopher Song, Corey E. Ventetuolo, James Simmons and Philip Haines
J. Cardiovasc. Dev. Dis. 2024, 11(8), 246; https://doi.org/10.3390/jcdd11080246 - 9 Aug 2024
Cited by 2 | Viewed by 1158
Abstract
Right ventricular (RV) dysfunction is associated with poor prognosis in acute respiratory failure (ARF). Our study evaluates the efficacy of RV strain in detecting RV dysfunction in ARF patients requiring invasive mechanical ventilation (IMV) compared to tricuspid annular plane systolic excursion (TAPSE). In [...] Read more.
Right ventricular (RV) dysfunction is associated with poor prognosis in acute respiratory failure (ARF). Our study evaluates the efficacy of RV strain in detecting RV dysfunction in ARF patients requiring invasive mechanical ventilation (IMV) compared to tricuspid annular plane systolic excursion (TAPSE). In this retrospective study involving 376 patients diagnosed with ARF and requiring IMV, we extracted clinical and outcome data from patient records. RV global longitudinal strain (RVGLS), free wall longitudinal strain (FWLS), and TAPSE were measured retrospectively using speckle tracking echocardiography (STE) and traditional echocardiography, respectively. We divided the cohort into three groups: TTE during IMV (TTE-IMV, 223 patients), before IMV (TTE-bIMV, 68 patients), and after IMV (TTE-aIMV, 85 patients). Multivariable regression analysis, adjusted for covariates, revealed significantly higher RVGLS and FWLS in the groups not on IMV at the time of TTE compared to the TTE-IMV group. Specifically, the TTE-bIMV group showed higher RVGLS (β = 7.28, 95% CI 5.07, 9.48) and FWLS (β = 5.83, 95% CI 3.36, 8.31), while the TTE-aIMV group exhibited higher RVGLS (β = 9.39, 95% CI 6.10, 12.69) and FWLS (β = 7.54, 95% CI 4.83, 10.24). TAPSE did not reveal any significant differences across the groups. Our study suggests an association between IMV and lower RVGLS and FWLS in ARF patients, indicating that IMV itself may contribute to RV dysfunction. RVGLS and FWLS appear to be more sensitive than TAPSE in detecting changes in RV function that were previously subclinical in patients on IMV. Prospective studies with TTE before, during, and after IMV are necessary to assess the primary driver of RV dysfunction and to prognosticate STE-detected RV dysfunction in this population. Full article
(This article belongs to the Special Issue Critical Care in Modern Cardiology)
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11 pages, 682 KiB  
Article
Peripartum Takotsubo Cardiomyopathy: A Review and Insights from a National Registry
by Ravi Vazirani, Emilia Blanco-Ponce, Manuel Almendro Delia, Agustín C. Martín-Garcia, Clara Fernández-Cordón, Aitor Uribarri, Oscar Vedia, Alessandro Sionis, Jorge Salamanca, Miguel Corbí-Pascual, Alberto Pérez-Castellanos, Manuel Martínez-Selles, Víctor Manuel-Becerra, Sergio Raposeiras-Roubín, David Aritza-Conty, Javier Lopez-País, Marta Guillén-Marzo, Carmen Lluch-Requerey and Iván J. Núñez-Gil
J. Cardiovasc. Dev. Dis. 2024, 11(2), 37; https://doi.org/10.3390/jcdd11020037 - 25 Jan 2024
Cited by 1 | Viewed by 2210
Abstract
Takotsubo syndrome (TTS) during the peripartum period is a relevant cause of morbidity in this population; its clinical course and prognosis, compared to the general TTS population, is yet to be elucidated. Our aim was to analyze the clinical features and prognosis of [...] Read more.
Takotsubo syndrome (TTS) during the peripartum period is a relevant cause of morbidity in this population; its clinical course and prognosis, compared to the general TTS population, is yet to be elucidated. Our aim was to analyze the clinical features and prognosis of peripartum TTS in a nationwide prospective specifically oriented registry database and consider the published literature. Peripartum TTS patients from the prospective nationwide RETAKO registry—as well as peripartum TTS patients from the published literature—were included, and multiple comparisons between groups were performed in order to assess for statistically and clinically relevant prognostic differences between the groups. Patients with peripartum TTS exhibit a higher prevalence of secondary forms, dyspnea, atypical symptoms, and echocardiographic patterns, as well as less ST-segment elevation than the general TTS population. In the literature, patients with peripartum TTS had a higher Killip status on admission. TTS during the peripartum period has a higher prevalence of angina and dyspnea, as well as physical triggers, neither of which are related to a worse prognosis. Killip status on admission was higher in the literature for patients with TTS but with excellent mid- and long-term prognoses after the acute phase, despite mostly being secondary forms. Full article
(This article belongs to the Special Issue Critical Care in Modern Cardiology)
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Review

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13 pages, 1057 KiB  
Review
Sepsis Management in the Cardiac Intensive Care Unit
by Yichi Zhang, Michael T. McCurdy and Jonathan Ludmir
J. Cardiovasc. Dev. Dis. 2023, 10(10), 429; https://doi.org/10.3390/jcdd10100429 - 17 Oct 2023
Cited by 6 | Viewed by 11974
Abstract
Septic shock management in the cardiac intensive care unit (CICU) is challenging due to the complex interaction of pathophysiology between vasodilatory and cardiogenic shock, complicating how to optimally deploy fluid resuscitation, vasopressors, and mechanical circulatory support devices. Because mixed shock portends high mortality [...] Read more.
Septic shock management in the cardiac intensive care unit (CICU) is challenging due to the complex interaction of pathophysiology between vasodilatory and cardiogenic shock, complicating how to optimally deploy fluid resuscitation, vasopressors, and mechanical circulatory support devices. Because mixed shock portends high mortality and morbidity, familiarity with quality, contemporary clinical evidence surrounding available therapeutic tools is needed to address the resultant wide range of complications that can arise. This review integrates pathophysiology principles and clinical recommendations to provide an organized, topic-based review of the nuanced intricacies of managing sepsis in the CICU. Full article
(This article belongs to the Special Issue Critical Care in Modern Cardiology)
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