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Non-Pulmonary Complications of Critical Care pp 1–18Cite as

Cardiovascular Complications

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Part of the book series: Respiratory Medicine ((RM))

Abstract

Cardiovascular complications are a common occurrence while caring for the critically ill patient. Problems such as atrial fibrillation (A fib), acute myocardial infarction, cardiac arrest, cardiac tamponade, and ventricular fibrillation are not uncommon in critical illness. Treatment of these conditions should be focused on prompt organized assessment and care to ensure rapid stabilization of the patient. Treatment of A fib should be focused on conversion back to sinus rhythm in some instances versus rate control with nodal blocking agents. Care of acute myocardial infarction requires determination for the need of invasive management versus medical management, as well as antiplatelet medications and systemic anticoagulation. Cardiac arrest should be treated with cardiopulmonary resuscitation and provision of rapid defibrillation for shockable causes of cardiac arrest. Echocardiography should be considered to aid in diagnosis during rapid deterioration of patients. Selected patients who have return of spontaneous circulation post arrest should be quickly evaluated for utility of targeted temperature management in order to attenuate the systemic and neurologic effects of post resuscitation syndrome.

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References

  1. Annane D, Sebille V, Duboc D, Le Heuzey JY, Sadoul N, Bouvier E, et al. Incidence and prognosis of sustained arrhythmias in critically ill patients. Am J Resp Crit Care Med. 2008;178(1):20–5.

    Article  PubMed  Google Scholar 

  2. Walkey AJ, Wiener RS, Ghobrial JM, Curtis LH, Benjamin EJ. Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis. JAMA. 2011;306(20):2248–54.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Chapman MJ, Moran JL, O’Fathartaigh MS, Peisach AR, Cunningham DN. Management of atrial tachyarrhythmias in the critically ill: a comparison of intravenous procainamide and amiodarone. Intensive Care Med. 1993;19(1):48–52.

    Article  CAS  PubMed  Google Scholar 

  4. Moran JL, Gallagher J, Peake SL, Cunningham DN, Salagaras M, Leppard P. Parenteral magnesium sulfate versus amiodarone in the therapy of atrial tachyarrhythmias: a prospective, randomized study. Crit Care Med. 1995;23(11):1816–24.

    Article  CAS  PubMed  Google Scholar 

  5. Balser JR, Martinez EA, Winters BD, Perdue PW, Clarke AW, Huang W, et al. Beta-adrenergic blockade accelerates conversion of postoperative supraventricular tachyarrhythmias. Anesthesiology. 1998;89(5):1052–9.

    Article  CAS  PubMed  Google Scholar 

  6. Hanna EB, Glancy DL. ST-segment depression and T-wave inversion: classification, differential diagnosis, and caveats. Cleve Clin J Med. 2011;78(6):404–14.

    Article  PubMed  Google Scholar 

  7. Yasue H, Touyama M, Kato H, Tanaka S, Akiyama F. Prinzmetal’s variant form of angina as a manifestation of alpha-adrenergic receptor-mediated coronary artery spasm: documentation by coronary arteriography. Am Heart J. 1976;91(2):148–55.

    Article  CAS  PubMed  Google Scholar 

  8. Lockerman ZS, Rose DM, Cunningham Jr JN, Lichstein E. Postoperative ST-segment elevation in coronary artery bypass surgery. Chest. 1986;89(5):647–51.

    Article  CAS  PubMed  Google Scholar 

  9. Minor Jr RL, Scott BD, Brown DD, Winniford MD. Cocaine-induced myocardial infarction in patients with normal coronary arteries. Ann Intern Med. 1991;115(10):797–806.

    Article  PubMed  Google Scholar 

  10. Masip J, Roque M, Sanchez B, Fernandez R, Subirana M, Exposito JA. Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis. JAMA. 2005;294(24):3124–30.

    Article  CAS  PubMed  Google Scholar 

  11. Shepard Jr JW, Pevernagie DA, Stanson AW, Daniels BK, Sheedy PF. Effects of changes in central venous pressure on upper airway size in patients with obstructive sleep apnea. Am J Resp Crit Care Med. 1996;153(1):250–4.

    Article  PubMed  Google Scholar 

  12. Caples SM, Gay PC. Noninvasive positive pressure ventilation in the intensive care unit: a concise review. Crit Care Med. 2005;33(11):2651–8.

    Article  PubMed  Google Scholar 

  13. Mehta S, Jay GD, Woolard RH, Hipona RA, Connolly EM, Cimini DM, et al. Randomized, prospective trial of bilevel versus continuous positive airway pressure in acute pulmonary edema. Crit Care Med. 1997;25(4):620–8.

    Article  CAS  PubMed  Google Scholar 

  14. Masip J, Betbese AJ, Paez J, Vecilla F, Canizares R, Padro J, et al. Non-invasive pressure support ventilation versus conventional oxygen therapy in acute cardiogenic pulmonary oedema: a randomised trial. Lancet. 2000;356(9248):2126–32.

    Article  CAS  PubMed  Google Scholar 

  15. Nava S, Carbone G, DiBattista N, Bellone A, Baiardi P, Cosentini R, et al. Noninvasive ventilation in cardiogenic pulmonary edema: a multicenter randomized trial. Am J Resp Crit Care Med. 2003;168(12):1432–7.

    Article  PubMed  Google Scholar 

  16. Eikelboom JW, Anand SS, Malmberg K, Weitz JI, Ginsberg JS, Yusuf S. Unfractionated heparing and low-molecular weight heparin in acute coronary syndrome without ST elevation: a meta-analysis. Lancet. 2000;355(9219):1936–42.

    Article  CAS  PubMed  Google Scholar 

  17. De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, et al. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med. 2010;362(9):779–89.

    Article  PubMed  Google Scholar 

  18. Thiele H, Zeymer U, Neumann FJ, Ferenc M, Olbrich HG, Hausleiter J, et al. Intraaortic balloon support for myocardial infarction with cardiogenic shock. N Engl J Med. 2012;367(14):1287–96.

    Article  CAS  PubMed  Google Scholar 

  19. Meaney PA, Nadkarni VM, Kern KB, Indik JH, Halperin HR, Berg RA. Rhythms and outcomes of adult in-hospital cardiac arrest. Crit Care Med. 2010;38(1):101–8.

    Article  PubMed  Google Scholar 

  20. Kim YM, Yim HW, Jeong SH, Klem ML, Callaway CW. Does therapeutic hypothermia benefit adult cardiac arrest patients presenting with non-shockable initial rhythms? A systematic review and meta-analysis of randomized and non-randomized studies. Resuscitation. 2012;83(2):188–96.

    Article  PubMed  Google Scholar 

  21. Lundbye JB, Rai M, Ramu B, Hosseini-Khalili A, Li D, Slim HB, et al. Therapeutic hypothermia is associated with improved neurologic outcome and survival in cardiac arrest survivors of non-shockable rhythms. Resuscitation. 2012;83(2):202–7.

    Article  PubMed  Google Scholar 

  22. Hypothermia after Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med. 2002;346(8):549–56.

    Article  Google Scholar 

  23. Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002;346(8):557–63.

    Article  PubMed  Google Scholar 

  24. Wenzel V, Lindner KH, Baubin MA, Voelckel WG. Vasopressin decreases endogneous catecholamin plasma concentrations during cardiopulmonary resuscitation in pigs. Crit Care Med. 2000;28(4):1096–100.

    Article  CAS  PubMed  Google Scholar 

  25. Stiell IG, Hebert PC, Wells GA, Vandemheen KL, Tang AS, Higginson LA, et al. Vasopressin versus epinephrine for inhospital cardiac arrest: a randomised controlled trial. Lancet. 2001;358(9276):105–9.

    Article  CAS  PubMed  Google Scholar 

  26. Gueugniaud PY, David JS, Chanzy E, Hubert H, Dubien PY, Mauriaucourt P, et al. Vasopressin and epinephrine vs. epinephrine alone in cardiopulmonary resuscitation. N Engl J Med. 2008;359(1):21–30.

    Article  CAS  PubMed  Google Scholar 

  27. Kudenchuk PJ, Cobb LA, Copass MK, Cummins RO, Doherty AM, Fahrenbruch CE, et al. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med. 1999;341(12):871–8.

    Article  CAS  PubMed  Google Scholar 

  28. Dorian P, Cass D, Schwartz B, Cooper R, Gelaznikas R, Barr A. Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med. 2002;346(12):884–90.

    Article  CAS  PubMed  Google Scholar 

  29. Stub D, Bernard S, Duffy SJ, Kaye DM. Post cardiac arrest syndrome: a review of therapeutic strategies. Circulation. 2011;123(13):1428–35.

    Article  PubMed  Google Scholar 

  30. Mongardon N, Dumas F, Ricome S, Grimaldi D, Hissem T, Pene F, et al. Postcardiac arrest syndrome: from immediate resuscitation to long-term outcome. Ann Intensive Care. 2011;1(1):45.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Storm C, Nee J, Roser M, Jorres A, Hasper D. Mild hypothermia treatment in patients resuscitated from non-shockable cardiac arrest. Emerg Med J. 2012;29(2):100–3.

    Article  PubMed  Google Scholar 

  32. Kilgannon JH, Jones AE, Shapiro NI, Angelos MG, Milcarek B, Hunter K, et al. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA. 2010;303(21):2165–71.

    Article  CAS  PubMed  Google Scholar 

  33. Nielsen N, Wetterslev J, Cronberg T, Erlinge D, Gasche Y, Hassager C, et al. Targeted temperature management at 33 degrees C versus 36 degrees C after cardiac arrest. N Engl J Med. 2013;369(23):2197–206.

    Google Scholar 

  34. Testori C, Sterz F, Behringer W, Haugk M, Uray T, Zeiner A, et al. Mild therapeutic hypothermia is associated with favourable outcome in patients after cardiac arrest with non-shockable rhythms. Resuscitation. 2011;82(9):1162–7.

    Article  PubMed  Google Scholar 

  35. Choi HA, Ko SB, Presciutti M, Fernandez L, Carpenter AM, Lesch C, et al. Prevention of shivering during therapeutic temperature modulation: the Columbia anti-shivering protocol. Neurocrit Care. 2011;14(3):389–94.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Vermont, 89 Beaumont Avenue, Given Bldg. D208, Burlington, VT, 05405, USA

    Ryan D. Clouser D.O.

  2. Division of Pulmonary and Critical Care, University of Vermont, HSRF 220, 149 Beaumont Avenue, Burlington, VT, 05405-0075, USA

    Gilman Allen M.D.

Authors
  1. Ryan D. Clouser D.O.
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  2. Gilman Allen M.D.
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Corresponding author

Correspondence to Ryan D. Clouser D.O. .

Editor information

Editors and Affiliations

  1. Pulmonary, Critical Care, and Sleep, Harvard Medical School Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

    Jeremy B. Richards

  2. Pulmonary and Critical Care, University of Vermont College of Medicine, Burlington, Vermont, USA

    Renee D. Stapleton

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Clouser, R.D., Allen, G. (2014). Cardiovascular Complications. In: Richards, J., Stapleton, R. (eds) Non-Pulmonary Complications of Critical Care. Respiratory Medicine. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-0873-8_1

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  • DOI: https://doi.org/10.1007/978-1-4939-0873-8_1

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-0872-1

  • Online ISBN: 978-1-4939-0873-8

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