Hospital Medicine Alert – July 1, 2016

July 1, 2016

• Delaying Intubation in Severe Alcohol Withdrawal

  Delaying intubation until aspiration or cardiopulmonary decompensation did not affect mortality but increased the incidence of pneumonia and length of stay.

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• Rivaroxaban in the Real World

  A large Phase IV registry study shows that rivaroxaban is associated with a very low incidence of major bleeding, death, or stroke. Also, adherence to therapy was much higher than observed in other studies with vitamin K antagonists.

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• Communication Facilitators Potentially Can Improve Care for the Sickest ICU Patients

  Highly trained communication facilitators who counseled families and met with physicians and nurses were shown to decrease symptoms of depression in family members at six months and decreased ICU length of stay without affecting mortality.

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• New Analysis of COGENT Data Supports Proton Pump Inhibitor Benefit with Low and High Aspirin Doses

  A dedicated analysis of the COGENT trial involving coronary artery disease patients on dual antiplatelet therapy shows comparable risks of gastrointestinal and cardiovascular events between low- and high-dose aspirin, and similar benefits of prophylactic proton pump inhibitor therapy.

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• Acetazolamide in Mechanically Ventilated Patients with COPD: Is There a Benefit?

  Compared to placebo, the use of acetazolamide in mechanically ventilated patients with COPD does not significantly reduce the duration of mechanical ventilation.

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