Cardiac Arrest In Intensive Care Unit Research Articles

The Study of Congestive Heart Failure as a Risk Factor of Cardiac Arrest in ICU

Cardiovascular disease, especially congestive heart failure, is the second most common cause of death after stroke In Indonesia, current data on cardiac arrest in the ICU, especially those related to CHF, are still limited. This study aimed to determine the relationship between congestive heart failure and cardiac arrest in Intensive Care Unit (ICU) inpatients. The study used an analytic observational method with a cross-sectional research design. To find the relationship between the two variables, a regression test was performed on subjects with congestive heart failure and cardiac arrest in the ICU. Data was collected from 316 subjects, including 111 Congestive Heart Failure (CHF) subjects and 205 without CHF. Of the 111 CHF subjects, 51 subjects (45.9%) experienced cardiac arrest, and 60 subjects (54.1%) did not experience cardiac arrest. In comparison, the 205 subjects without CHF comprised 125 subjects (61.0%) who experienced cardiac arrest, and 80 subjects (39.0%) did not experience cardiac arrest. There is a relationship between congestive heart failure (CHF) and cardiac arrest, but CHF is not the only risk factor for cardiac arrest (p<0.05; OR 0.75). Congestive heart failure is associated with cardiac arrest in ICU patients with a relative risk of 0.75 times compared to subjects without congestive heart failure. Future research is needed to find the cause of congestive heart failure leading to cardiac arrest.

Early and mid-term outcome of CABG surgery in diabetic and non-diabetic patients in a tertiary care hospital in Bangladesh

Background: Previous trials showed that diabetic patients had worse in-hospital and long term outcome after coronary artery bypass grafting (CABG) than non diabetic ones. However, the majority of such studies was carried out in western countries and limited information is available for the Asian population.
 Objective: The present study was intended to determine the impact of diabetes on early and mid-term outcome among patients undergoing CABG surgery in a tertiary care hospital in Bangladesh.
 Methods: This study was performed at Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh, from January to June 2014. Based on enrollment criteria, 202 patients (115 diabeticsand 87 non-diabetics) were enrolled and evaluated for their early outcome (within 30 days of operation) and midterm (after 30 days post-operatively). Patients with known diabetes or preoperative fasting blood sugar ≥6.4 mmol/L or random blood sugar ≥11.1 mmol/L were considered as diabetics. The outcome measures were ICU stay, reopening for bleeding, atrial fibrilation, cardiac arrest, total hospital stay, left ventricular ejection fraction and mortality.
 Results: Diabetic patients in this study had higher prevalence of hypertension, hyperlipidaemia, and renal failure. The diabetic and the non diabetic groups received a mean number of grafts of 3.2±1.06 and 2.81±1.21, respectively, Postoperative mortality in diabetic and non-diabetic patients at early and mid-term were not significantly different in univariate analysis (4.3% vs. 2.3%, p= 0.352) and (2.6 % vs. 2.3%,p = 0.630) respectively. The mean intensive care unit (ICU) stay in diabetic and non-diabetic were same (3.5days) but total hospital stay was significantly higher in the former group (one day or more). Re-opening for bleeding, atrial fibrilation and cardiac arrest in ICU were found higher in DM than those in non-DM group (28.7%vs.20.7%,10.4% vs. 8% and 4.2% vs.1.1% respectively).
 Conclusion: Although the mortality rate of diabetic patients following CABG surgery was in significantly higher than their non-diabetic counterparts. Morbidity was also a bit higher. Strict perioperative glyacemic control could reduce morbidity and mortality in diabetic patients undergoing CABG.