Hospital Medicine Alert – April 1, 2008

April 1, 2008

• Effects of Eliminating Daily Chest X-Rays in the ICU

  This single-center, prospective, observational study finds that the utility of a routine daily chest x-ray (CXR) for an ICU patient is quite limited. A change in practice to ordering CXR only when clinically indicated did not adversely impact patient outcome, but reduced CXR volume and overall costs.

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• Arterial Line Insertions in the ICU: To Gown or Not To Gown?

  Although the incidence of catheter-related bloodstream infections from arterial catheters is low, arterial catheters have similar colonization rates and catheter-related bloodstream infections as concurrently sited and identically managed central venous catheters.

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• Special Feature: S. maltophilia : A Multi-Resistant Nosocomial Pathogen

  Stenotrophomonas maltophilia (formerly known as Pseudomonas maltophilia, Xanthomonas maltophilia) is a motile, gram-negative bacillus that is widely distributed in nature, particularly in water and soil. It rarely causes disease in healthy hosts, but it can be a particularly troublesome pathogen in highly compromised, hospitalized patients.

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• Can Your Patient's SES Status have an Adverse Effect on You?

  A physicians' survey in Connecticut indicates that a patient's socioeconomic status (SES) affected their clinical management decisions.

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• Is Stenting Better Than CABG for Left Main Stenosis?

  Left main coronary artery stenosis is one of the primary indications for coronary artery bypass graft surgery (CABG). Recently, a number of non-randomized studies and registries have suggested that stenting, using current techniques and devices, may be a feasible alternative to CABG.

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