Publications by authors named "Rene M'Pembele"

Vital sign monitoring in palliative care could support symptom management and prediction, though its utility at the end-of-life remains critically discussed. This study aims to test a wireless device for continuous vital sign monitoring at the end-of-life. This prospective observational study included adult terminal care patients in the palliative care unit at a tertiary-care hospital (05/2023-03/2024).

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Background: Patients undergoing cardiac surgery are at increased risk for postoperative complications, making early postoperative risk evaluation crucial. Recent studies have shown that copeptin, a neurohumoral marker, is associated with major adverse events after noncardiac surgery. However, data on its role after cardiac surgery are scarce.

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Large, randomized trials testing omega-3 polyunsaturated fatty acid (ω-3 PUFA) supplementation to reduce cardiovascular events have reported contradictory results. Interpretation of these trials is challenging, because different dosages and formulations of ω-3 PUFA were tested. Furthermore, the exact mechanisms for the reduction in cardiovascular events are unclear.

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Introduction: Heart failure is a frequent comorbidity in patients undergoing non-cardiac surgery and an acknowledged risk factor for postoperative mortality. The associations between stable chronic heart failure and postoperative outcomes have not been explored extensively. The aim of this study was to determine associations between stable chronic heart failure and its peri-operative management and postoperative outcomes after major non-cardiac surgery.

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Background: Heart transplantation remains the gold standard treatment of end stage heart failure. The prognosis of heart transplantation has continuously improved, with a 10-yr survival of 53%. Dexmedetomidine is commonly used as a sedative in cardiac patients.

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Risk prediction models are an established component of the preoperative evaluation. In its guidelines the European Society for Cardiology proposes several risk scores but the benefit of these is mostly unclear for clinicians. This article describes the individual steps in the preparation of a valid prediction model with a focus on the parameters, discrimination, calibration and external validation.

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Background: The American Heart Association (AHA) recently defined the cardiovascular-kidney-metabolic syndrome (CKM) as a new entity to address the complex interactions between heart, kidneys, and metabolism. The aim of this study was to assess the outcome impact of CKM syndrome in patients undergoing noncardiac surgery.

Methods: This is a secondary analysis of a prospective international cohort study including patients aged ≥45 years with increased cardiovascular risk undergoing noncardiac surgery.

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Background: Cardiac risk evaluation prior to noncardiac surgery is fundamental to tailor peri-operative management to patient's estimated risk. Data on the degree of adherence to guidelines in patients at cardiovascular risk in Europe and factors influencing adherence are underexplored.

Objectives: The aim of this analysis was to describe the degree of adherence to [2014 European Society of Cardiology (ESC)/European Society of Anaesthesiology (ESA) guidelines] recommendations on rest echocardiography [transthoracic echocardiography (TTE)] and to stress imaging prior to noncardiac surgery in a large European sample and to assess factors potentially affecting adherence.

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Importance: Cardiopulmonary resuscitation (CPR) is an exceptional physical situation and may lead to significant psychological, spiritual, and social distress in patients and their next of kin. Furthermore, clinicians might experience distress related to a CPR event. Specialist palliative care (sPC) integration could address these aspects but is not part of routine care.

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Objectives: In patients undergoing heart transplantation (HTX), preoperative liver impairment and consecutive hypoalbuminaemia are associated with increased mortality. The role of early postoperative hypoalbuminaemia after HTX is unclear. This study investigated the association between early postoperative hypoalbuminaemia and 1-year mortality as well as 'days alive and out of hospital' (DAOH) after HTX.

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Background: Impella™ is increasingly used in cardiogenic shock. However, thromboembolic and bleeding events are frequent during percutaneous mechanical circulatory support (pMCS).

Objective: Therefore, we aimed to explore the optimal anticoagulation regime for pMCS to prevent thromboembolism and bleedings.

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Background: The recently published ESAIC guidelines highlight the clinical value of cardiac troponins (cTn) and B‑type natriuretic peptides (BNP) for risk assessment in patients undergoing noncardiac surgery.

Objective: Summary of the ESAIC guideline recommendations.

Material And Methods: The evidence for the recommendations was extracted from studies that investigated the perioperative role of cTn and BNP as prognostic factors, for risk prediction and for therapeutic guidance.

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Article Synopsis
  • Patients with severe injuries need special care to help their hearts and bodies heal.
  • Doctors gave a medicine called tranexamic acid (TXA) to some patients to stop bleeding, but it can also sometimes harm the heart.
  • In a study of 297 injured patients, giving TXA before arriving at the hospital did not seem to hurt or help their heart injury levels.
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Article Synopsis
  • Recent years have seen a growing emphasis on cardiac biomarkers for patients undergoing noncardiac surgery, highlighting their potential importance in clinical practice.
  • The focused guidelines aim to offer updated recommendations regarding the use of cardiac troponin and B-type natriuretic peptides before, after, and during noncardiac surgical procedures.
  • A systematic review led to the identification of critical outcomes and varying levels of certainty in the evidence, resulting in practical recommendations and statements for clinicians when using these biomarkers.
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Background: Orthotopic heart transplantation (HTX) is the gold standard to treat end-stage heart failure. Numerous risk stratification tools have been developed in the past years. However, their clinical utility is limited by their poor discriminative ability.

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The two main surgical options to treat end-stage heart failure are heart transplantation (HTx) or left ventricular assist device (LVAD) implantation. In hemodynamically stable patients, the decision for HTx listing with or without LVADs is challenging. We analyzed the impact of both options on days alive and out of hospital (DAOH) and survival.

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Article Synopsis
  • Severe trauma can hurt the heart, which might increase the chances of serious heart problems and kidney damage while in the hospital.
  • A study looked at 353 injured adults to see how heart injury affects these issues.
  • The results showed that having heart injury means a higher risk for both serious heart problems (MACE) and kidney issues (AKI) while being treated in the hospital.
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The adverse impact of common diseases like diabetes mellitus and acute hyperglycemia on morbidity and mortality from myocardial infarction (MI) has been well documented over the past years of research. In the clinical setting, the relationship between blood glucose and mortality appears linear, with amplifying risk associated with increasing blood glucose levels. Further, this seems to be independent of a diagnosis of diabetes.

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Background: Antithrombotic regimen in patients on oral anticoagulation (OAC) post-percutaneous coronary intervention (PCI) is challenging. At least, one antiplatelet agent in combination with OAC is recommended after PCI for 6-12 months. Clopidogrel is used most frequently in this setting.

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The number of patients waiting for heart transplantation (HTX) is increasing. Thus, identification of outcome-relevant factors is crucial. This study aimed to identify perioperative factors associated with days alive and out of hospital (DAOH)-a patient-centered outcome to quantify life impact-after HTX.

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Introduction: Hemodynamic assessment is crucial after heart transplantation (HTX) or left ventricular assist device (LVAD) implantation. Gold-standard is invasive assessment via thermodilution (TD). Noninvasive pulse contour analysis (NPCA) is a new technology that is supposed to determine hemodynamics completely noninvasive.

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