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Heart failure in general and cardiac transplant patients with COVID-19

World Journal of Cardiology 2022年第7期14卷 392-402页

作者： Munish Sharma Gowthami Sai kogilathota Jagirdhar kalpalatha k guntupalli Rahul kashyap Salim Surani Department of Medicine Baylor College of MedicineHoustonTX 77030United States Department of Medicine St Michaels'Medical CenterNewarkNJ 07102United States Department of Pulmonary Critical Care and SleepBaylor College of MedicineHoustonTX 77030United States Department of Anesthesiology Mayo ClinicRochesterMN 55905United States Department of Medicine Texas A&M UniversityBryanTX 77807United States

Coronavirus disease 2019(COVID-19)is primarily an infection of the respiratory tract,but it can have multisystem *** complications of COVID-19 can range from acute myocardial injury,cardiac arrhythmias,or heart failure,amongst *** failure(HF)in COVID-19 can be a de novo process or due to worsening of pre-existing cardiovascular *** in a patient with COVID-19 not only poses challenges in clinical presentation and management of COVID-19 but also affect prognosis of the *** article aims to succinctly revisit the implications of this pandemic regarding pre-existing HF or new-onset HF based on prevailing *** also focuses on the management and special recommendations from prior studies and guidelines.

关键词： COVID-19 Coronavirus Cardiomyopathy Heart failure Cardiomyopathy

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Intensive care unit complications and outcomes of adult patients with hemophagocytic lymphohistiocytosis: A retrospective study of 16 cases

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World Journal of Critical Care Medicine 2018年第6期7卷 73-83页

作者： Sumit kapoor Christopher k Morgan Muhammad Asim Siddique kalpalatha k guntupalli Department of Critical Care Medicine Montefiore Medical Center Department of Pulmonary Critical Care and Sleep Baylor College of Medicine

AIM To study the management, complications and outcomes of adult patients admitted with hemophagocytic lymphohistiocytosis(HLH) in the intensive care unit(ICU).METHODS We performed a retrospective observational study of adult patients with the diagnosis of "HLH" admitted to the two academic medical ICUs of Baylor College of Medicine between 01/01/2013 to 06/30/2017. HLH was diagnosed using the HLH-2004 criteria proposed by the Histiocyte *** Sixteen adult cases of HLH were admitted to the medical ICUs over 4 *** age of presentation was 49 years and 10(63%) were males. Median Sequential Organ Failure Assessment(SOFA) score at the time of ICU admission was 10. Median ICU length of stay(LOS) was 11.5 d and median hospital LOS was 29 d. Septic shock and acute respiratory failure accounted for majority of diagnoses necessitating ICU admission. Septic shock was the most common ICU complication seen in(88%) patients, followed by acute kidney injury(81%) and acute respiratory failure requiring mechanical ventilation(75%). Nine patients(56%) developed disseminated intravascular coagulation and eight(50%) had acute liver failure. 10 episodes of clinically significant bleeding were *** system organ failure was the most common cause of death seen in 12(75%)patients. The 30 d mortality was 37%(6 cases) and 90 d mortality was 81%(13 cases). There was no difference in mortality based on age(above or less than 50 years), SOFA score on ICU admission(more than or less than 10),immunosuppression, time to diagnose HLH or direct ICU admission versus floor *** HLH is a devastating disease associated with poor outcomes in ICU. Intensivists need to have a high degree of clinical suspicion for HLH in patients with septic shock/multi system organ failure and progressive bi/pancytopenia who are not responding to standard management in ICU.

关键词： Lymphohistiocytosis Cytopenia Hypercytokinemia Hemophagocytosis Shock

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