Blood Pressure and ICU - Cardiovascular Update

Cardiac Monitors

All About Cardiovascular System and Disorders

MAY 3, 2024

Current multi parameter monitors have invasive and non-invasive blood pressure, respiration, pulse oximetry, pacemaker sensing and various other monitoring possibilities. Sometimes the number of alarms is so many that ICU staff may develop “alarm fatigue” and stop responding to alarms.

ICU

ICU Blood Pressure Pacemaker General Cardiology

Abstract WP8: Targeted versus High-Intensity Monitoring Following Intravenous Thrombolysis in Acute Ischemic Stroke

Stroke Journal

JANUARY 30, 2025

We report the outcomes of a 12-hour targeted-intensity monitoring (TIM) pathway for low-risk post-IVT patients.Methods:Post-IVT patients were considered low-risk if their NIHSS < 10, blood pressure < 180/105 without medical intervention, level of consciousness was preserved, and no high-risk vessel stenosis/occlusion was present.

Thrombolysis

Thrombolysis ICU Strokes Stroke

Abstract TMP18: Establishing Aggressive Time Targets for the Identification and Treatment of Intracerebral Hemorrhage Improves Patient Outcomes

Stroke Journal

JANUARY 30, 2025

The 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association states that we should control blood pressure, reverse anticoagulation, and get the patient to a specialized inpatient stroke unit. 30 day readmission rate dropped to 3.23%Conclusions:Having

Hemorrhage

Hemorrhage Blood Pressure Outcomes ICU

Webinars

Bridging Innovation & Patient Care: The Growing Role of AI

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Does this T wave pattern mean anything?

Dr. Smith's ECG Blog

OCTOBER 23, 2023

She was admitted to the ICU where subsequent ECGs were performed: ECG at 12 hours QTc prolongation, resolution of T wave alternans ECG at 24 hours Sinus tachycardia with normalized QTc interval. She had an uneventful ICU course and was extubated for ongoing care with the inpatient psychiatric service.

Tachycardia

Tachycardia Cardiac Arrest ICU Blog

Abstract 016: Endovascular Coiling of a Left L3 Radicular Artery Mycotic Aneurysm

Stroke: Vascular and Interventional Neurology

NOVEMBER 9, 2023

Postoperatively, the patient was hypertensive to a systolic blood pressure of 220 mmHg that was controlled with a nicardipine infusion that was gradually weaned off once the patient’s vitals were stable while in the Neuro‐ICU. CT‐guided biopsy of the L3‐L4 disc was also obtained.

Aneurysm

Aneurysm Peripheral Arterial Disease Coronary Artery Disease ICU

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

Dr. Smith's ECG Blog

JANUARY 9, 2024

The pacing rate was increased without clinical improvement and the patient was transferred to the ICU for closer monitoring/treatment. Therefore — Just because a patient remains awake and alert with an adequate blood pressure for an extended period of time does not rule out the possibility sustained VT.

Tachycardia

Tachycardia Electrophysiology Atrial Flutter Ischemia

A crashing patient with an abnormal ECG that you must recognize

Dr. Smith's ECG Blog

MARCH 12, 2018

Despite heparin and supportive care, the patients mental status and blood pressure worsened. She had an uneventful ICU course and improved steadily over the course of a week. NT pro BP returned at 10,676 pg/mL. She was diagnosed with massive PE and given intravenous tPA with rapid improvement in hemodynamics and mental status.

Chest Pain

Chest Pain Pulmonary Embolism Tachycardia

A young woman in her early 20s with syncope

Dr. Smith's ECG Blog

JULY 12, 2020

The cardiac monitor showed sinus rhythm but the automatic blood pressure cuff was not reading. We arrived in the resuscitation bay and recorded a heart rate of 115 bpm and blood pressure of 50/30 mm Hg. Why would she have such varying blood pressure? She was discharged home in good condition.

Pericarditis

Pericarditis Hospital Ultrasound Blood Pressure

Machine-learning based risk prediction of in-hospital outcomes following STEMI: the STEMI-ML score

Frontiers in Cardiovascular Medicine

OCTOBER 9, 2024

Final models were chosen to optimise area under the curve (AUC) score while ensuring interpretability.ResultsOverall, 128 (6.9%) patients died in hospital, with 292 (15.7%) patients requiring ICU admission and 373 (20.0%) patients with LVEF < 40%. for ICU admission, and 0.74 for in-hospital mortality, 0.78 for LVEF < 40%.

STEMI

STEMI Hospital ICU Outcomes

Abstract 4140751: “A silent death: Right heart clot in transit” Acute sub-massive pulmonary embolism

Circulation

NOVEMBER 11, 2024

He was administered a therapeutic dose of low-molecular weight heparin and transferred to the ICU. Unfortunately, on day 8 of hospitalization, he became bradycardic with no recordable blood pressures, and went into pulseless electrical activity soon after with an eventual demise.In

Embolism

Embolism Pulmonary Ultrasound ICU

A middle aged man with unwitnessed cardiac arrest

Dr. Smith's ECG Blog

APRIL 6, 2018

The arterial line blood pressure immediately jumped from 80/40 with blunted monomorphic waveform to 140s/80s with bounding, normal-appearing waveform. He made it to the ICU, however the patient unfortunately expired approximately 24 hours after ICU admission.

Cardiac Arrest

Cardiac Arrest Tachycardia Defibrillator ICU

Could you have prevented this young man's cardiac arrest?

Dr. Smith's ECG Blog

JULY 24, 2018

Compartment pressures in the right calf were all 40-50 mmHg. At that time his diastolic blood pressure was also hovering between 45 and 55 mmHg. Upon arrival in the ICU, before getting Continuous Veno-Venous Hemodialysis (CVVHD), his potassium had risen again to 7.8

Cardiac Arrest

Cardiac Arrest Chest Pain Tachycardia ICU

Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?

Dr. Smith's ECG Blog

MAY 5, 2022

On arrival in the ED, he was hypotensive with a systolic blood pressure in the 70s. He was admitted to the ICU and transferred emergently to a facility where he could undergo emergent dialysis as a part of further evaluation and management. Fluid resuscitation was initiated. Here is the initial ED ECG: What do you think?

Chest Pain

Chest Pain Bradycardia Cardiac Arrest STEMI

Extension of an ICU-based noninvasive model to predict latent shock in the emergency department: an exploratory study

Frontiers in Cardiovascular Medicine

DECEMBER 22, 2024

However, the usefulness of an ICU-based model to predict latent shock risk in an emergency department (ED) setting remains unclear. An adult noninvasive model was constructed based on the MIMIC-IV-ICU v3.0 Multiple regression analysis of the MIMIC-IV-ICU and MIMIC-IV-ED datasets showed mostly similar characteristics.

ICU

ICU Critical Care Blood Pressure Research

Never send a chest pain patient home without measuring troponin. What is masquerading bundle branch block? And, and, and.

Dr. Smith's ECG Blog

APRIL 18, 2025

Orthostatic blood pressures were recorded and confirmed orthostatic hypotension. The patient was transferred to the ICU on pressors, where a repeat bedside echo showed an LVEF of 10-15%. He suffered another cardiac arrest in the ICU with ROSC after another dose of epinephrine and one round of CPR.

Chest Pain

Chest Pain Cardiac Arrest Tachycardia ICU

Cardiac Monitors

Abstract WP8: Targeted versus High-Intensity Monitoring Following Intravenous Thrombolysis in Acute Ischemic Stroke

Abstract TMP18: Establishing Aggressive Time Targets for the Identification and Treatment of Intracerebral Hemorrhage Improves Patient Outcomes

Webinars

Does this T wave pattern mean anything?

Abstract 016: Endovascular Coiling of a Left L3 Radicular Artery Mycotic Aneurysm

A fascinating electrophysiology case. What is this wide complex tachycardia, and how best to manage it?

A crashing patient with an abnormal ECG that you must recognize

A young woman in her early 20s with syncope

Machine-learning based risk prediction of in-hospital outcomes following STEMI: the STEMI-ML score

Abstract 4140751: “A silent death: Right heart clot in transit” Acute sub-massive pulmonary embolism

A middle aged man with unwitnessed cardiac arrest

Could you have prevented this young man's cardiac arrest?

Another deadly and confusing ECG. Are you still one of the many people who will be fooled by this ECG, or do you recognize it instantly?

Extension of an ICU-based noninvasive model to predict latent shock in the emergency department: an exploratory study

Never send a chest pain patient home without measuring troponin. What is masquerading bundle branch block? And, and, and.

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