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Patients admitted in an Emergency Department with acute respiratory distress are attributed to acute cardiogenic pulmonary oedema. The European Society of Cardiology's first-line therapy of acute pulmonary oedema is diuretics and nitrite derivatives. As compared to NIV and standard oxygen therapy, HFNO reduces the mortality rate in patients with acute hypoxemic respiratory failure hospitalized in an ICU. According to some studies, HFNO is superior to standard oxygen therapy in acute pulmonary oedema, and may have a similar medical effect to NIV. However, there is no study that has compared the tolerance of patients admitted in an ED with acute pulmonary oedema and treated with HFNO or NIV. Patients will be measured under medical care using a comfort numerical scale from 0 to ten very uncomfortable.
Source link: https://clinicaltrials.gov/ct2/show/NCT04971213
Patients with CS often received mechanical circulatory assistance, and the venoarterial extracorporeal membrane oxygenator is a key aid in achieving chronic organ perfusion. Patients with CS requiring VA ECMO will be referred to a prospective randomized controlled pilot study to investigate the effectiveness of extracorporeal cytokine and lipopolysaccharide adsorption using Oxiris on humoral inflammation parameters, hemodynamics, and clinical results in patients with CS requireing VA ECMO.
Source link: https://clinicaltrials.gov/ct2/show/NCT05642273
Early revascularization with percutaneous coronary intervention or coronary artery bypass graft has been attributed to improved clinical outcomes, but the rate of mortality remains high in the mechanical circulatory support era. The selection of a revascularization program is a critical factor in improving clinical outcomes in CS patients with multivessel disease, since clinically significant non-infarct artery stenosis or occlusion in comparison to an IRA can be found in 70% to 80% of patients with AMI complicated by CS. To improve overall myocardial perfusion and hemodynamic stability for patients with AMI and CS, the 2013 American College of Cardiology/American Heart Association and the 2017 European Society of Cardiology guidelines recommend considering PCI of severe stenosis in non-IRA during a primary procedure. Patients in the CULPRIT-SHOCK trial may have a mild case of CS and few patients were provided with MCS devices. The latest large United States registry from National Cardiovascular Data Registry showed that the benefits of multi-vessel PCI in patients with non-ST-segment elevation MI and CS were more apparent in those requiring MCS, rather than the CULPRIT-SHOCK trial. According, the new randomized trial found that immediate multi-vessel PCI would be more effective in clinical outcomes relative to the culprit lesion-only PCI for AMI and multi-vessel disease in a new cohort of CS patients with advanced form of CS patients who require veno-arterial extracorporeal membrane oxygenators.
Source link: https://clinicaltrials.gov/ct2/show/NCT05527717
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