Electrocardiograms of the month. Arrhythmia.
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Biomedical subjects
Publications and source records attributed to J Frieden.
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After the introduction of a 22-bed, monitored intermediate cardiac care unit (ICCU), cardiac care unit admissions increased by 15.7%. A further increase in patient admissions of 37% was permitted by direct admissions to the ICCU from the emergency room. The duration of the hospital stay of patients with acute myocardial infarct was shortened by three days. The success rate of cardiac resuscitation improved, and potentially serious arrhythmias were treated more promptly. Hospital costs were substantially reduced by the use of a convalescent unit for patients whose ICCU stay was uncomplicated. Concentration of cardiac patients and specialized staff and equipment permitted more efficient care.
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The hemodynamic effects of a 10 mg bolus of edrophonium chloride followed by a continuous infusion of 0.25 to 1.0 mg per minute, were determined in unanesthetized patients with significant myocardial disease. The effect on heart rate of the drug was negated by studying a group of nine patients with complete heart block and permanently implanted ventricular pacemakers. After the 10 mg bolus, two of the nine patients experienced dizziness, nausea and abdominal cramps associated with a mild decrease in peripheral vascular resistance. There was no significant change in cardiac index, mean blood pressure, brachial artery upstroke time, corrected ejection time, or left ventricular systolic ejection time. This study demonstrated that the continuous infusion of 0.25 to 1.0 mg per minute of edrophonium chloride following a 10 mg loading dose, had no significant effect on myocardial function.
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