Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 30th European Heart Diseases and Heart Failure Congress Amsterdam, Netherlands .

Day 2 :

  • Plenary Tracks
Location: Orion 3

Session Introduction

Veena Dhawan

Postgraduate Institute of Medical Education and Research, India

Title: Aberrant DNA methylation of M1-macrophage genes in coronary artery disease

Time : 12:30-13:00

Speaker
Biography:

Veena Dhawan has completed her PhD from PGIMER and did Post-doctoral Research at Minneapolis USA and Post-graduate Institute of Medical Education and Research, Chandigarh, India. At present, she is working as a Professor in the Department of Experimental Medicine and Biotechnology at PGIMER a National Institute of repute. She has published around 90 papers in reputed journals and written around seven book chapters.

 

Abstract:

Macrophage heterogeneity within atherosclerotic lesions has attracted much interest owing to the importance of balance between M1 and M2 population. Though, it remains unknown how macrophage heterogeneity is regulated. Moreover, the regulation of macrophage polarization and activation also involve DNA methylation. However, it remains unknown which genes are directly regulated by DNA methylation. The aim of the study was to assess the gene-specific promoter DNA methylation status of M1/ M2 macrophage polarization markers STAT1, STAT6, MHC2, IL12b, iNOS, JAK1, JAK2 and SOCS5 in peripheral blood mononuclear cells of CAD patients. A casecontrol study was performed with 25 CAD patients and 25 controls to investigate the gene-specific promoter DNA methylation status using MS-HRM analysis. Our data indicates that there was a clear-cut difference in the pattern of gene-specific promoter DNA methylation of above mentioned genes in CAD patients as compared to controls. A consistent hypomethylated pattern was observed for most of the samples including both CAD patients and controls, which was heterogeneous DNA methylation as evident by their melting profiles. A significant difference was observed between the mean percentage methylation of STAT1, IL12b, MHC2, iNOS, JAK1 and JAK2 in CAD patients and control subjects. Our data showed that MS-HRM assay is a rapid and inexpensive method for qualitatively investigation and identification of aberrant gene-specific promoter DNA methylation changes in CAD. Since, monocytes and macrophages play a significant role in atherosclerosis, we propose that epigenetic markers including gene-specific promoter DNA methylation based on monocyte/macrophage might aid as diagnostic markers or drug targets for clinical application. Therefore, skewing the M1/M2 balance towards a more preferable phenotype through DNA methylation-related interventions may offer novel possibilities for atherosclerotic disease management.

 

Speaker
Biography:

Cindy Rodrigues Cleto is a sixth year Medical Student at the University of Liverpool, UK. She has completed her MReS in Cardiovascular Science at the University of Newcastle where she carried out this research.

Abstract:

Introduction: Primary cilia on endocardial cells could prove to be a cause of congenital heart defects. Endocardial cells mainly contribute to the outflow tract (OFT) and atrioventricular (AV) endocardial cushion; later developing into the four heart valves. Knocking out IFT88 creates abnormal primary cilia and in turn causes cardiac malformations.

Aims: The aims of this study were to establish the spatiotemporal expression of primary cilia on endocardial derived cells; and by using an IFT88 mouse model, to discover if defecting to the primary cilia in endocardial derived cells causes an abnormal cardiac phenotype?

Methods: For the spatiotemporal expression of primary cilia, Tie2Cre positive mouse embryos of age’s e10.5-e12.5 were stained with anti-green fluorescent protein and acetylated tubulin to show the endothelial cells and primary cilia respectively. For the IFT88 mouse model, three mutants were collects at e15.5; two were hematoxylin and eosin stained to look at histology and one was stained with acetylated tubulin to show any defect in the primary cilia.

Results: The spatiotemporal expression of primary cilia mainly highlighted that there is an abundance of cilia in the OFT and AV endocardial cushions at e10.5 and e11.5 but this significantly drops by e12.5. The IFT88 mouse model showed that knocking out IFT88 significantly decreases the number of primary cilia in mutants, causing cardiac malformations including atrio-ventricular septal defects and dysplastic mitral and tricuspid valves.

Conclusion: Primary cilia are present in the endocardial derived cells at earlier time points. Knocking out IFT88 does produce defective cilia that lead to cardiac malformations.

Flavio Burgarella

Heart Friends Around The World, Italy

Title: Heart friends around the world get heart better

Time : 14:00-16:00

Speaker
Biography:

Flavio Burgarella is a Cardiologist and Physiatrist, Head of the Cardiac Rehabilitation Center of San Pellegrino Terme, in the province of Bergamo, Italy. He is registered with the National Associations of Journalists. He is the Founder and Executive Director of Heart Friends Around The Word, (www.hfatw.org) international association, affiliated with the World Heart Federation, whose aim is to promote the prevention and rehabilitation of cardiovascular diseases in developing nations. He is the Founder and Chairman of Burgarella Quantum Healing (BQH) (www.quantummind.eu ) with the aim to promote the helping relationship between Science and Consciousness. He is an Honorary Member of the Russian Federation of Cardiology and the Cuban Atherosclerosis Society. He got for his activity the Sodalem Honoris Causa by the Society of MD of the Slovak Republic. He has published several books on health education and five books of poetry. He organized several campaigns to promote health through physical activity, including three jogging tour of Italy in relay. He is enrolled at the Science and Consciousness Group of the Faculty of Psychology of the University of Padua and collaborates with Egocreanet at the Incubator of the University of Florence (Italy).

Abstract:

Heart Friends Around The World (www.hfatw.org) Get Heart Better is a psycho - energetic - informational approach based on the brain heart consistency through breathing, awareness and BQH transformation. HFATW Get Heart Better uses the research of Heart Math (www.heartmath.com) and the scientific exploration of Quantum Mind (www.quantummind.eu) through the Burgarella Quantum Healing (BQH) method. HFATW Get Heart Better is a program that provides free training for cardiologists participating in the association and a training for health personnel who will take care of the management of the patient with myocardial infarction or operated to the heart in the first and second phase of cardiological rehabilitation. It is also useful in the clinical stability phase following a heart failure. It has been demonstrated its validity in the control of mental and emotional stress and in increasing, through the brain heart consistency, the heart rate variability, measurable and referable to the health of the heart. Once the consistency of the heart is obtained, it is possible to increase the resilience to the state of illness through awareness, mainly obtained through meditation on the present moment and the acceptance without judgment of cenesthetic, auditory perceptions and compulsive thoughts that may appear during practice. The part of scientific exploration related to Quantum Mind is based on the ability of operators to perceive the biofields with the second attention, to enter the state of awareness of non-awareness, such as the one existing in the space between two thoughts and to make the transformation on the basis of intention, an innovative process based on the ability to have experience of bringing the principles of quantum physics into clinical practice. With the appropriate training all the health workers involved in the first and second phase of rehabilitation can achieve the desired results. The foundation of the HFATW Get Heart Better program is based on heart-centered breathing while feelings of acceptance about appreciation, gratitude, compassion, and healing are felt. After a short time of practice, you automatically enter the "field of the heart" that can be appreciated, with the BQH perception, like an oscillatory movement, a cradle, consisting of two points at the antipodes, represented by the oscillation relative to the systolic and diastolic movement of the heart. The perception of this field leads to a slight altered state of consciousness, to the increase of HR Variability and to the heart - brain coherence. When we are aware of the field of the heart, we exploit the state of coherence present here, which corresponds to the coherence of the “unified field”. The field of the heart has a toric shape and represents a torsion field that has the property to propagate in space and to interfere with the material objects for the exchange of information. Thus, dwelling in the field of the heart dwells in a quantum field, in a reality with unlimited potential. This field also has morphogenetic characteristics, as it is located inside and around a morphic unit, at the heart, which organizes its characteristic structure and activity. The field of the heart with morphogenetic characteristics has its own intrinsic memory which, if taken up, can be useful in the morphogenesis process, in making its contribution to the regeneration of cardiac cells.

 

 

Speaker
Biography:

Yin Hua Zhang is a Cardiovascular Physiologist evaluating cardiac metabolism in health and diseased hearts. She has been working on nitric oxide and redox-regulation of myocardial contractility and cellular mechanisms. She is now focusing on obesity and hypertension and cardiovascular remodeling.

Abstract:

Transglutaminase 2 (TG2) is a calcium-dependent enzyme and in the cardiovascularsystem, TG2 has been reported to be involved in the development of cardiac hypertrophy, vessel remodeling, and age related vascular stiffness. Interestingly, TG2 is implicated in the regulation of muscle metabolism via modification of respiratory complexes and the ADP/ATP transporter in the mitochondria of myocardium. However, the role of TG2 in the heart during conditions of pressure overload in relation to fatty acid(FA) oxidation has not been investigated. Hence, we investigated the involvement of TG2 in cardiomyocytes contraction under FA supplementation. Using TG2 inhibitor and TG2-deficient mice, we demonstrated that FA-supplementation activated TG2 and increased ATP level and contractility of cardiac myocyte from normal heart. By contrast, in cardiac myocytes from angiotensin-II treated rats and mice, the effects of FA-supplementation on TG2 activity, ATP level and myocyte contraction were abolished. Furthermore, TG2 was inhibited by S-nitrosylation and its level increased in hypertensive myocytes. Treatment with inhibitor for neuronal nitric oxide synthase (nNOS) restored FA-induced increase of TG2 activity and myocyte contraction. Moreover, intracellular Ca2+ levels were increased by FA-supplementation in both normal and hypertensive myocytes, showing that S-nitrosylation of TG2 but not alteration of intracellular Ca2+ levels are responsible for contractile dysfunction. These results indicate that TG2 plays a critical role in the regulation of myocyte contractility by promoting FA metabolism and provide a novel target for preventing contractile dysfunction in heart with high work-load.

  • Heart Disease | Molecular Cardiology | Cardiovascular Medicine | Heart Failure | Arrhythmias
Speaker

Chair

Normunds Sikora

Children’s University Hospital, Latvia

  • Video Presentation
Location: Salon II & III

Session Introduction

Paola Vidal Rojo

La Salle A C University, Mexico

Title: Treating congenital heart diseases with high tech procedures in an unequal country

Time : 13:30-14:10

Speaker
Biography:

Paola Vidal Rojo has completed her basic education by Cambridge University of London, has graduated from the Faculty of Medicine of the Universidad La Salle AC, and later graduated from the specialties of two of the largest Health Institutes in our country and in Latin America. She has initially in Pediatrics of Children's Hospital of Mexico, and later subspecialty in Pediatric Cardiology of the National Institute of Cardiology Ignacio Chávez, fulfilling functions of Head of Residents of the subdivision of Pediatrics. And finally she is high specialty in Medicine in Pediatric and Fetal Echocardiography in the Children's Hospital of Mexico Federico Gómez.

Abstract:

Mexico is a country with many inequalities, which are very notable, amongst
other things, in high tech healthcare. Congenital heart diseases require in average $5,000 USD per child for a surgical treatment. Given that our average
per capita income is quite low, only as few as 10% of the population can afford
such healthcare, and even though 98% of the population have some sort of social security service, these are saturated, and patients may have to wait up to twoyears to be able to have surgery. And more so, over two million people have no access to medical services. So, we must turn to social enterprises and non-profit associations to be able to cope with this problem, and still are left with many patients without proper care. There are several areas within the country that do not have extracorporeal pump machines for open heart surgery, so they must perform surgeries without them, such as corpectomy or pulmonary banding, some of which are palliative surgeries. Many of the patients we attend arrive relatively late, considering their state. For example, we operate tetralogies of Fallot after two years of age, or anomalous pulmonary venous connections after three months. All these because of lack of planning; we have the resources and the infrastructure, but we do not yet find a way to properly manage these deficits. And so, we have so far eight nonprofit associations performing surgical procedures in congenital heart diseases throughout the country. Amongst all of them, over 1,000 children a year have been operated on, just a small percentage of all that we calculate are still awaiting surgery. Every year, more that 22,000 new children with congenital heart diseases are born, and we try to shorten the list. The first non-profit was founded in 1995, and the newest one barely this year. And all of them need mainly two things: Patients, and economical resources. We need pediatricians to redirect patients to the specialists as soon as possible and to begin medical treatment in case these referrals are not entirely feasible, and paediatric cardiologist to be familiar with all governmental, profit and nonprofit options for the patient’s benefit. We intend with this paper to share our experiences and our results in case some other countries may find it useful, as well as to urge the need for pediatric alertness, the need for resources (both human and economic), as well as an early referral, to beable to help all he children awaiting surgery to improve their quality of life.

Speaker
Biography:

Abstract:

Background: The effect of yoga practice on the depression is evaluated worldwide. We assessed the effect of yoga on the depression, human’s energy and physical bodies in our institute and observed the correlation between subjective effect of practice and charts of GDV camera (energy body and chakra system).
 
Methods: Clients of detox yoga retreat program (asana, pranayama, meditation, special detox vegetarian or vegan nutrition daily) were participated in the study. Subjective effect of yoga practice was assessed with internal questionnaire, depression symptoms were evaluated with HRDS17 Scale. The relationships between the symptoms of depression, subjective effect of yoga practice and GDV charts before and after the program were examined. 
 
Results: One hundred four clients with a median age of 33, 3 years (18-73), out of 93.5% had positive subjective effect of the practice. The mean HRDS17 score was 12 (mild depression) before start of the program, after the competition of the program the mean score was four (normal). The amount of energy increased in 65% of cases; the chakra system was more align and stable in 75% after the
practice.
 
Conclusion: There is a need to develop effective yoga programs for preventive care of depression and explore therapeutic effect of yoga.

  • Poster Presentation
Location: Salon II & III
Speaker
Biography:

Rim Frikha is an Associate Professor in Medicine and a PhD student at National School of Engineer in the University of Sfax. She is expert in Histology-Embryology and Molecular Genetic on Onco-Hematology. She has published numerous papers in reputed journals in these fields.

Abstract:

Introduction: High-dose methotrexate (HD-MTX) is widely used in the acute lymphoblastic leukemia (ALL). The effect of 5, 10-methylenetetrahydrofolate reductase (MTHFR) variants; mainly the C677T on the risk of MTX-induced toxicity was largely investigated and enrolled in meta-analysis. However, the results were inconsistent.
 
Aim: The aim of this study was to investigate the relationship between the C677T variant of the MTHFR gene, and the MTX-induced toxicity in Tunisian ALL patients.
 
Materials & Methods: It was a retrospective study among 35 patients with ALL. Toxicity data was recorded after high-dose methotrexate (HD-MTX) course. Genotyping of MTHFR C677T was performed by polymerase chain reactionrestriction fragment length polymorphism (PCR- RFLP).
 
Results: Patients with ALL carrying the C677T variant were at a higher risk of developing hepatotoxicity (RR=1.3 times).
 
Conclusion: The present result highlights the impact of MTHFR C677T variant on the MTX toxicity-induced in ALL and further studies with larger numbers of participants worldwide are required before definitive conclusions.

  • E- Poster
Location: Salon II & III

Session Introduction

Pavaloiu Ramona-Daniela

National Institute for Chemical-Pharmaceutical Research and Development (ICCF), Romania

Title: Cyto-Lycium-cytoprotective effect of ethanolic extract of Lycium barbarum leaves against hydrogen peroxide induced oxidative damage in L-929 cells
Speaker
Biography:

Pavaloiu Ramona-Daniela is currently a Post-doctoral Researcher at the Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest and also at the National Institute for Chemical-Pharmaceutical Research and Development–ICCF, Bucharest, Romania. She is a Member of 11 research projects (two as Project Manager), 14 publications (six ISI papers as First Author, five ISI papers as a Co-Author, three publications in BDI journals), one book chapter, three patents, seven patent applications, two contributions in conference proceedings, 25 communications at international and national conferences and 29 citations. Her expertise lies in innovative drug delivery systems-liposomes, nanoparticles, drug release and mathematical modeling of drug release.

Abstract:

Lycium barbarum (fam. Solanaceae) known as wolfberry or goji, is widely grown in the subtropical areas of the world, in Japan and Coreea, in countries from South-East of Asia and in Europe as well. In the last years, goji berries play an important role in the traditional Chinese medicine and it has attracted much attention due to their diverse biological activities, such as: liver and kidney protector and eyesight enhancer. The aim of this paper is to investigate the cytoprotective effect of an ethanolic extract of wolfberry leaves (Lycium barbarum) against H2O2 induced oxidative damage in L-929 cells. L.barbarum extract was characterized concerning its qualitative chemical composition, total phenol content and antioxidant activity by high performance liquid chromatography, folin-ciocalteu method and DPPH assay. Also, it was investigated whether pretreatment (one hour or 24 hours) with L. barbarum leaves extract had an effect on L-929 mouse fibroblasts cells cytotoxicity induced by H2O2. Data showed the presence of chlorogenic and caffeic acids and a total phenol content of 18.30 mg GAE/g dry material. DPPH method revealed significant antioxidant activity. L. barbarum extract showed a moderate cytotoxic activity. A prolonged pretreatment (24 hours) with L. barbarum extract was able to protect L-929 murine fibroblast cells against H2O2 cytotoxicity. These preliminary findings suggest that Lycium barbarum leaves can be used for the development of dietary supplements.

  • Plenary Tracks
Location: Orion 3

Session Introduction

Ahdi Amer

Wayne State University School of Medicine, USA

Title: Does pacifier use in infancy decrease the risk of obesity?
Speaker
Biography:

Ahdi Amer is a Professor of Pediatrics at Wayne State University School of Medicine, Detroit, Michigan. He has expertise in the field of General Academic Pediatrics and Pediatric Infectious Diseases. His main areas of interest are vaccine development, vaccine safety, and various pediatric infectious and dermatological disorders. He has conducted clinical research supported by the WHO, Merck and Pfizer on vaccines and other infectious and dermatological topics. He has authored and co-authored >40 articles published in peer-reviewed journals. He has presented in several national and international settings on vaccine-related topics.

Abstract:

Abstract

Background & Objective: Non-nutritive sucking (NNS) using a finger or pacifier is a natural reflex for infants. In gratifying this innate need, NNS can be soothing and may facilitate a smooth transition to sleep. We hypothesized that infants with their innate desire for gratification through NNS may overfeed if the bottle or breast is constantly offered instead of a pacifier. Our primary objective was to determine whether the use of pacifier in early infancy is associated with lower incidence of obesity at 9-15 month of age.

Methods: Parents of 399 infants 9 to 15 months old visiting the General Academic Pediatric Clinic were interviewed. They were asked whether a pacifier was used consistently ≥9 months and the reason for its use. BMIs at birth, 6 months and on the day of interview were calculated.

Results: Of the 399 recruited infants, 204 (51%) used a pacifier consistently for ≥9 months and 195 (49%) were non-user. More infants in the pacifier non-user group were significantly either overweight, 40 (21%) with BMI ≥85% or obese, 32 (16%) with BMI ≥95% than in the pacifier user group: 22 (11%) and 22 (11%) respectively (P.003). Formula fed infants accounted for the increased number of overweight and obese infants in the non-user group.

Conclusions: The use of a pacifier in infancy was associated with a lower incidence of obesity at 9-15 month of age. Given the current prevalence of childhood obesity, we believe that offering a pacifier between feeds can provide a protective effect against infantile obesity.

Speaker
Biography:

Abel Gidey is one of the youngest energetic and affable pediatricians working in Ayder specialized Comprehensive Hospital, Ethiopia. He has finished his Medical Doctor in 2014 and is an Assistant Professor of Pediatrics since October 2018. He was one of the speaker at the World Pediatric Conference December 2018 which was held in Abu Dhabi, UAE.

Abstract:

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown cause that can affect the multiple organs of the body. Cardiac involvement among children with SLE ranges in various studies from 12 to 54 percent. The manifestations are varied in nature and severity. Valvular lesion is the most encountered form of heart disease in systemic lupus erythematosus (SLE). The mitral valve being the commonest site. We report a case of 16 years old male adolescent who was referred from district hospital in Tigray region. He was newly diagnosed Systemic lupus erythematosus with rapid progression of valvular insufficiency and congestive heart failure. This is one of the rare case reports with diagnostic and therapeutic challenge.

Speaker
Biography:

Lidia Sileshi Tefera has completed her graduation from Hawassa University school of Medicine with a Medical degree and completed her Residency in Pediatrics and Child health from Addis Ababa University School of Medicine. She is the Head of Department of Pediatrics and Child health in Adare General Hospital and Affiliated Staff of Hawassa University College of Medicine and Health Sciences.

Abstract:

While the health-related quality of life (HRQOL) of children with congenital heart defects is primarily affected, caring for a child with birth defect has an impact on the family’s quality of life as well. Understanding the level of quality of life of the parents, which is likely to vary in different cultural settings, beliefs and parental educational status may help to implement educational programs and other interventional measures that may improve the HRQOL of parents of such children. This cross-sectional comparative study reports the health-related quality of life of mothers of children with congenital heart diseases in a sub-Saharan setting. Mean age of the mothers in the study group was 32.2±7.1 years where as that of the control group was 30.5±6.5 years (p=.054). One hundred-four children had congenital cardiac lesions classified as mild to moderate while 31 patients had severe lesions. On average, mothers in the study group showed poor performance on the Short Form-36 (SF-36) survey with statistically significant differences on all sub-scales including general health perception, physical functioning, role physical, role emotional, social functioning, bodily pain, vitality and mental health. Severity of the congenital heart defect was not associated with statistically significant difference in the health-related quality of life of the mothers. Mothers of children with congenital heart disease in our study have significantly lower quality of life in all domains of SF-36 compared to the control group. Planning and devising a strategy to support these mothers may need to be part of management and clinical care of children with congenital heart diseases.

Jimmy Chen and Angela Harrinanan

Centennial College - Morningside Campus, Canada

Title: Utilization of pain simulation in nursing education
Speaker
Biography:

Angela Harrinanan is a nursing professor at Centennial College with extensive pain management experience in acute pain service. She also works at Centennial Health Simulation center as a simulation support for faculty with limited simulation experience. Angela holds a Master in Nursing from University of Toronto, specializing in Nurse Practitioner.

Abstract:

Introduction: Pain management has been identified as one critical element in nursing practice and students are required to assess and manage pain appropriately. Many studies support the effectiveness of simulation as a teaching methodology; however there is a gap in measuring students’ learning outcomes in pain simulation. The purpose of this study is to assess students’ knowledge of pain assessment and management. Furthermore this research study is to explore students’ perspectives in pain simulation.

Research Question/Hypothesis: Will the pain simulation experience improve students’ knowledge of pain (a) assessment and (b) management? (c) What is the students’ perspective/experience when participating with the pain simulation?

Methods: A mixed methods approach was utilized to gain an understanding of student’s learning of pain assessment and management in simulation. A convenience sample of 159 year two BSc Nursing students were recruited for Adapted Pain Knowledge and Attitude Pre- and Post-Simulation Surveys during their scheduled simulation experience in winter 2018 semester. Additionally, 10 students participated in focus group sessions to explore nursing students’ experience in pain simulation.

Results: Descriptive and qualitative data were analyzed with five themes emerging: Developing appropriate pain assessment skills, administrating pain medication with clinical reasoning, enlightening pain management from patient’s perspective, developing clinical decision making and providing new perspective of pain management. Themes were derived from qualitative focus group findings and aligned with the pre- and post-pain knowledge and attitude survey (PPKAS) quantitative results (McCaffery and Ferrel, 2012). Key learning points that student have gained from pain simulation experience are: Communicating effectively with patient, do not underestimate patient’s pain, acquiring “solid” pain medication knowledge to provide safe patient care, “Practice makes perfect” and tailoring pain medication based on patient’s conditions.

Conclusion: The PPKAS surveys and focus group discussions reveal student’s learning perspectives and suggestions for future pain simulation to; supporting student learning in pain simulation; fostering student centered learning simulation environment and; providing faculty support in pain simulation.

Speaker
Biography:

Stavros Theologou works as a Registered ITU Nurse in Cardiac Surgery ICU of ‘Evangelism’s’ General Hospital of Athens. He completed a Post-graduate course in ‘Intensive Therapy Units and Emergency Nursing’ in Medical School of National and Kapodistrean University of Athens and a Post-graduate course in Health and Social Welfare Services in School of Business Administration of University of West Attica and currently is a PhD candidate in Medical School of Athens. He has also contributed in publications in several reputed scientific health journals.

1: Registered ITU Nurse, ΜSc, PhD (c) Cardiac Surgery ICU, ‘Evangelismos’ General Hospital of Athens, Greece.  

2: Research Fellow,  MSc,  PhD (c),  Department of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.

3: Assistant Professor, ΜSc, PhD,  Department of Economics of the University of Piraeus, Director at the Laboratory of the Health Economics and Management of University of Piraeus

Abstract:

Introduction: The hospitalization of post cardiac surgery ICU patients constitutes a complex mixture of procedures affected by a variety of clinical, administrational and technical aspects of care. The respective cost may drastically increase due to these patients’ increased clinical needs, including also the clinical state of delirium which is a quite common complication following this type of operation.

Methods: Τhe study included 179 consecutive patients who underwent open heart operation with cardiopulmonary bypass. The Confusion Assessment Method (CAM-ICU) was used for delirium diagnosis. Hospitalization outcomes were recorded by measuring certain intra - and post - operative procedure time intervals, along with the ICU and in-hospital length of stay as well.

Results:

A total of 179 patients post cardiac surgery were investigated, 129 of them were male and the rest 50 were female. The delirium complication was recorded in 20 out of 179 patients of the study (11.2%)

Bivariate analysis revealed that prolonged intraoperative time in cardiopulmonary bypass (p<0,001), prolonged sedation time (p=0,005) and prolonged length of stay with endotracheal tube (p<0,001) were significantly correlated with increased total health care cost.

Multivariate analysis showed that the level of complexity of the surgical operation (p<0,001), delirium complications (p<0,001) and the prolonged in-hospital length of stay (p<0,001), formulated altogether a group of factors for total health care cost increase.

Conclusions: A variety of factors seem to increase post cardiac surgery ICU patients’ total hospitalization cost and jeopardize quality of care and health outcomes. Resource management and monitoring, analytical process of health care costing in the Cardiac ICU and Ward, and recruitment of nursing staff with advanced