Background: Life-threatening problems are risks for critically ill patients. Moreover, they need complex care with carful coordination. In addition, nutritional support considered as fundamental aspect of a standard care of critically ill patients. Objectives: We aimed at evaluating the abdominal massage effect on gastrointestinal outcomes of critical ill patients with enteral feeding. Methods: Quasi-experimental research design was used in this study. The Swedish massage technique for abdomen was carried out twice daily for five consecutive days by the trained researcher. A convenience sample of 60 critically adult males with enteral feeding participated voluntarily in the study. Results:The results of this study revealed that, gastric residual volume was low with the study group than the control group during intervention period after abdominal massage. Also, a significant difference was noticed in last three days of the intervention between the study and control groups. Moreover, it was indicated that abdominal distension, vomiting, and constipation were low with the study group than the control group during the five consecutive days of intervention. Conclusion:This study provides promising evidence that massage of abdomen can be used with entirely fed critically ill patients to improve their gastrointestinal outcomes. This leads to a reduction in residual volume of gastric, distension of abdomen, constipation, and vomiting.

Funding Acknowledgements Type of funding sources: None. Introduction Heavy coronary thrombus burden is associated with increased periprocedural complications in ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI (PPCI)[1]. The prediction of such a burden can help in planning the PPCI procedure in the best way. The Global Registry of Acute Coronary Events (GRACE) 2.0 score is a useful non-invasive tool to predict major adverse events in STEMI patients [2]. Purpose to assess the difference in coronary thrombus burden in STEMI patients with low and high risk GRACE 2.0 score on admission. Methods We retrospectively studied 210 STEMI patients who presented to a single PPCI centre over a period of 6 months. We consecutively included all the patients who were eligible for PPCI according to the European Society of Cardiology (ESC) guidelines [2]. We excluded the patients who received fibrinolysis, who had a previous PCI and presented with in-stent thrombosis and those who presented more than 24 hours from the onset of chest pain. All procedures were done according to the Helsinki declaration of research on human beings. The study protocol was approved by the local research ethics committee. The GRACE 2.0 score was calculated at the time of presentation to the emergency department using the online calculator [3]. We divided the patients according to their GRACE 2.0 score into a high-risk score (more than 140) and a non-high-risk score(up to 140) groups according to the ESC guidance.2 We compared the two groups regarding various cardiovascular risk factors and the angiographic thrombus burden during the PPCI procedure. Two experienced interventional cardiologists (blinded to the allocation group) assessed the thrombus burden using the TIMI thrombus grades [4]. A heavy thrombus burden was defined as a thrombus grade of 4 or 5. A professional statistician carried out the statistical analysis using IBM SPSS 21.0 software. Results The baseline characteristics of the studied groups are shown in figure 1. Multivariate regression analysis did not show an influence of the different cardiovascular risk factors on the thrombus burden in the studied groups. The percentage of patients with a heavy thrombus burden was higher in the high-risk score group; however, the difference between the two groups was not statistically significant (44.6% vs 35.3%, P=0.46) (figure 2). This study is the first to assess the ability of the GRACE 2.0 score to predict the coronary thrombus burden in STEMI patients undergoing PPCI. The study is limited by the small number of patients included and the small geographical scale. Conclusion Although the GRACE 2.0 is a well-validated tool to predict the clinical prognosis in STEMI patients, it could not identify those patients with a high coronary thrombus burden in our small study. Further larger-scale studies are required to find other non-invasive tools to identify this high-risk cohort.

Funding Acknowledgements Type of funding sources: None. Introduction Studies demonstrated a link between the presence of HF on the admission of ACS patients and increased in-hospital morbidity and mortality. However, the literature did not establish the connection between the admission HF and the angiographic burden and the coronary vessel perfusion post-PPCI. Purpose To establish the correlation between acute HF on admission of STEMI patients, the coronary thrombus burden and the final coronary perfusion post PPCI. Methods We retrospectively studied 210 STEMI patients who presented to a single PPCI centre. We excluded post-fibrinolysis patients, patients with old stents and those who presented more than 24 hours after the onset of pain. We divided the studied cohort into two subgroups based on the presence of HF on presentation to the emergency department. We obtained Informed consent from all patients, and all procedures were done in compliance with the Helsinki declaration for research on human beings. Two blinded interventional cardiology consultants assessed the thrombus burden and coronary flow using TIMI grades of both variables. Results 20 patients (10%) of the studied group had HF on admission. There was no significant difference between the two subgroups regarding other cardiovascular risk factors (figure 1). The coronary thrombus burden did not differ significantly between the HF and no HF subgroups (50% vs 43.16%, respectively, p=0.557). However, the incidence of impaired coronary flow post-PPCI was significantly higher in the HF group (25% vs 8.4%, p=0.019) (figure 2). Multivariate logistic regression analysis showed that admission HF is an independent predictor of impaired perfusion post-PPCI ( OR= 5.49, 95% CI=1.54-19.49, p=0.01). Our study demonstrates the association between admission HF in STEMI patients undergoing PPCI and increased incidence of impaired coronary flow after PPCI. This finding was independent of the heavy coronary thrombus burden on angiography. Animal studies have demonstrated impaired coronary flow even in HF secondary to non-ischaemic causes.1,2 Possible mechanisms include impaired nitric oxide-mediated endothelium-dependent vasodilatation and enhanced vasoconstriction to mediators of neurohumoral activation.3 These mechanisms can explain our study's impaired coronary flow in HF patients. Conclusion Admission HF is an independent predictor of reduced coronary blood flow after PPCI. Timely treatment of STEMI patients can prevent HF development and improve their prognosis.

25.2-30.2). Predictors of patient satisfaction in the PD group were absence of pain during closure, decreased TTA, and drastic reductions in TTD; the latter contributed indirectly to significant cost-savings in the PD group (1,282.3 AE118.3 vs. 2,271.4 AE121.1 dollars, respectively; P<0.001) and incremental cost savings by strategy also favored closure over MC ($89,124.5).CONCLUSIONS ProGlide is safe and effective for femoral artery closure in patients who ambulate within 30 min after cardiac catheterization; all of which translated into improved patient satisfaction and substantial cost savings.BACKGROUND The clinical benefits of paxlitaxel-coated balloon angioplasty (PCB) have been extensively studied in bare metal stent in-stent restenosis (BMS-ISR) and in drug eluting stent in-stent restenosis (DES-ISR). The GARO Registry is a dedicated 'all comers' study in an unselected patient population with DES-ISR to elucidate the clinical benefits of PCB angioplasty for various types of DES-ISR in a routine clinical setting.