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Báo cáo y học: "Atrial fibrillation is not just an artefact in the ICU"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Atrial fibrillation is not just an artefact in the ICU. | Seguin and Launey Critical Care 2010 14 182 http ccforum.eom content 14 4 182 CRITICAL CARE COMMENTARY L__ Atrial fibrillation is not just an artefact in the ICU Philippe Seguin and Yoann Launey See related research by Meierhenrich etal. http ccforum.eom content 14 3 R108 Abstract Atrial fibrillation AF is common in the intensive care unit ICU and is particularly frequent 46 in septic shock patients. Inflammation favours AF in the general population and there is a growing body of evidence that inflammation also plays a role in AF occurring after cardiac surgery but also in the general ICU. How such a finding could modify the therapeutic approach remains elusive. The impact of AF on mortality is not clearly demonstrated in the ICU with AF reflecting essentially the severity of the underlying disease. Atrial fibrillation AF onset in the intensive care unit ICU is attracting widespread attention because of its frequency and prognostic significance. In the previous issue of Critical Care Meierhenrich and colleagues complete the description of new-onset AF in the ICU in a selected population of patients suffering from septic shock 1 . They found that 46 of their patients developed AF and this arrhythmia was significantly associated with increased ICU length of stay without affecting mortality. Interestingly they reported a significant and continuous increase in C-reactive protein levels the days before the occurrence of AF corroborating previous findings on the hypothesis of an inflammatory substrate in AF onset 2 . AF is the most significant arrhythmia in the ICU. The risk to develop AF in the ICU is largely superior to that of the general population but differs with regard to the type of ICU involved. Indeed the risk is estimated to be 4 in the general population from 4 to 9 in the general ICU and an incidence of 32 has been recently reported in a cardiac surgical ICU 3-9 . How could we explain such a difference In fact AF is considered both a cardiac disease