Institution
Sharp Memorial Hospital
Healthcare•San Diego, California, United States•
About: Sharp Memorial Hospital is a healthcare organization based out in San Diego, California, United States. It is known for research contribution in the topics: Heart failure & Transplantation. The organization has 342 authors who have published 477 publications receiving 23102 citations.
Topics: Heart failure, Transplantation, Ventricular assist device, Health care, Magnetic resonance imaging
Papers published on a yearly basis
Papers
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TL;DR: The use of a left ventricular assist device in patients with advanced heart failure resulted in a clinically meaningful survival benefit and an improved quality of life.
Abstract: Background Implantable left ventricular assist devices have benefited patients with end-stage heart failure as a bridge to cardiac transplantation, but their long-term use for the purpose of enhancing survival and the quality of life has not been evaluated. Methods We randomly assigned 129 patients with end-stage heart failure who were ineligible for cardiac transplantation to receive a left ventricular assist device (68 patients) or optimal medical management (61). All patients had symptoms of New York Heart Association class IV heart failure. Results Kaplan–Meier survival analysis showed a reduction of 48 percent in the risk of death from any cause in the group that received left ventricular assist devices as compared with the medical-therapy group (relative risk, 0.52; 95 percent confidence interval, 0.34 to 0.78; P=0.001). The rates of survival at one year were 52 percent in the device group and 25 percent in the medical-therapy group (P=0.002), and the rates at two years were 23 percent and 8 percent...
3,540 citations
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National Institutes of Health1, University of Washington2, Centers for Disease Control and Prevention3, University of Massachusetts Medical School4, University of Wisconsin-Madison5, Brown University6, Harvard University7, University of Texas Southwestern Medical Center8, Sharp Memorial Hospital9, Columbia University10, University of Minnesota11, University of North Carolina at Chapel Hill12, Boston Children's Hospital13
TL;DR: The recommended preventive strategies with the strongest supportive evidence are education and training of healthcare providers who insert and maintain catheters, and maximal sterile barrier precautions during central venous catheter insertion, which can reduce the risk for serious catheter-related infection.
Abstract: Background:Although many catheter-related blood-stream infections (CRBSIs) are preventable, measures to reduce these infections are not uniformly implementedObjective:To update an existing evidenced-based guideline that promotes strategies to prevent CRBSIsData Sources:The MEDLINE database, conference proceedings, and bibliographies of review articles and book chapters were searched for relevant articlesStudies Included:Laboratory-based studies, controlled clinical trials, prospective interventional trials, and epidemiologic investigationsOutcome Measures:Reduction in CRBSI, catheter colonization, or catheter-related infectionSynthesis:The recommended preventive strategies with the strongest supportive evidence are education and training of healthcare providers who insert and maintain catheters; maximal sterile barrier precautions during central venous catheter insertion; use of a 2% chlorhexidine preparation for skin antisepsis; no routine replacement of central venous catheters for prevention of infection; and use of antiseptic/antibiotic-impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (ie, education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis)Conclusion:Successful implementation of these evidence-based interventions can reduce the risk for serious catheter-related infection
985 citations
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TL;DR: In decompensated HF, ultrafiltration safely produces greater weight and fluid loss than intravenous diuretics, reduces 90-day resource utilization for HF, and is an effective alternative therapy.
956 citations
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University of Louisville1, University of Michigan2, Duke University3, University of Washington4, Ohio State University5, Johns Hopkins University6, Cleveland Clinic7, University of Rochester8, University of Minnesota9, Sharp Memorial Hospital10, University of Alabama at Birmingham11, Saint Barnabas Medical Center12, Columbia University13, Thoratec14
TL;DR: Key elements in managing patients supported with the new continuous-flow LVADs are proposed, including implants techniques, troubleshooting device problems, and algorithms for outpatient management, including the diagnosis and treatment of related problems associated with the HeartMate II.
Abstract: Continuous-flow left ventricular assist devices (LVAD) have emerged as the standard of care for advanced heart failure patients requiring long-term mechanical circulatory support. Evidence-based clinical management of LVAD-supported patients is becoming increasingly important for optimizing outcomes. In this state-of-art review, we propose key elements in managing patients supported with the new continuous-flow LVADs. Although most of the presented information is largely based on investigator experience during the 1,300-patient HeartMate II clinical trial, many of the discussed principles can be applied to other emerging devices as well. Patient selection, pre-operative preparation, and the timing of LVAD implant are some of the most important elements critical to successful circulatory support and are principles universal to all devices. In addition, proper nutrition management and avoidance of infectious complications can significantly affect morbidity and mortality during LVAD support. Optimizing intraoperative and peri-operative care, and the monitoring and treatment of other organ system dysfunction as it relates to LVAD support, are discussed. A multidisciplinary heart failure team must be organized and charged with providing comprehensive care from initial referral until support is terminated. Preparing for hospital discharge requires detailed education for the patient and family or friends, with provisions for emergencies and routine care. Implantation techniques, troubleshooting device problems, and algorithms for outpatient management, including the diagnosis and treatment of related problems associated with the HeartMate II, are discussed as an example of a specific continuous-flow LVAD. Ongoing trials with other continuous-flow devices may produce additional information in the future for improving clinical management of patients with these devices.
860 citations
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TL;DR: The HeartMate VE LVAS provides adequate hemodynamic support, has an acceptably low incidence of adverse effects, and improves survival in heart transplant candidates both inside and outside the hospital.
500 citations
Authors
Showing all 343 results
Name | H-index | Papers | Citations |
---|---|---|---|
Barbara Riegel | 101 | 507 | 77674 |
John Ross | 91 | 258 | 28177 |
David E. Shaw | 88 | 298 | 42616 |
Howard A. Rockman | 81 | 238 | 22395 |
Kirk L. Peterson | 63 | 185 | 14453 |
Daniel F. Heitjan | 63 | 233 | 17337 |
George Sakoulas | 55 | 202 | 13469 |
Cynthia Behling | 43 | 108 | 15553 |
Paul J. Ponganis | 43 | 117 | 4779 |
Bas A.J.M. de Mol | 43 | 211 | 5915 |
John P. Boehmer | 42 | 145 | 15087 |
Shane Meehan | 41 | 153 | 5998 |
Steven M. Steinberg | 41 | 121 | 5882 |
Ralph Shabetai | 37 | 118 | 8598 |
Valmik Bhargava | 37 | 142 | 4326 |