Hospital Medicine Alert – December 1, 2007

December 1, 2007

• Delayed Transfer to the ICU Increases LOS and Mortality

  Critically ill emergency department patients with a ≥ 6 hour delay in ICU transfer had an increased hospital length of stay and higher ICU and hospital mortality.

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• Predicting Respiratory Failure in Guillain-Barré Syndrome

  Phrenic nerve conduction studies may be a promising method to anticipate respiratory failure in patients with GBS.

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• Statin Withdrawal in Acute Stroke: Adverse Outcomes?

  Withdrawal of statin therapy in acute ischemic stroke may lead to increases in death and disability.

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• ECG Diagnosis of Acute Myocardial Infarction

  In patients admitted to hospital with possible AMI, the consideration of both ST-segment elevation and depression in the standard 12 lead-ECG recording significantly increases the sensitivity for the detection of AMI with only a slight decrease in the specificity.

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• New Drug for Atrial Arrhythmias

  Dronedarone was significantly more effective than placebo in maintaining sinus rhythm and in reducing the ventricular rate during recurrence of arrhythmia.

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• Micafungin for Invasive Candidiasis

  Micafungin at doses of both 100 mg and 150 mg daily was non-inferior to caspofungin in the treatment of invasive candidiasis and there was no significant difference in outcomes when the two doses of micafungin were compared.

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