Hospital Medicine Alert – April 1, 2017
April 1, 2017
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Vancomycin Combined with Piperacillin-Tazobactam Increases the Risk for Acute Kidney Injury
A retrospective cohort study found an increased risk of acute kidney injury for patients who received vancomycin in combination with piperacillin-tazobactam compared to those who received vancomycin plus cefepime (hazard ratio = 4.27; 95% confidence interval, 2.73-6.68). -
Do Antipsychotics Help with Delirium?
In palliative care patients suffering from delirium, managing delirium precipitants and individualized supportive strategies alone work better than adding risperidone or haloperidol. -
Hemoconcentration Associated with Lower Mortality in Acute Heart Failure
Among patients hospitalized for acute heart failure, hemoconcentration was associated with reduced 90-day mortality and may be a useful marker for guiding therapy. -
Hyperoxia in ICU Patients May Cause Harm
Patients randomized to maintain oxygen saturation between 94-98% experienced better outcomes than patients allowed to receive partial pressure of oxygen > 150 mmHg. -
High-sensitivity Cardiac Troponin
In patients with new-onset chest pain without ECG evidence of an ST-elevation myocardial infarction, conversion to the use of a high-sensitivity troponin T assay with three-hour retesting in three hospitals was compared to maintaining the fourth-generation troponin T assay with six-hour retesting in three other hospitals. The use of high-sensitivity troponin T resulted in lower ED length of stay and costs, without increasing the use of coronary angiography or stress testing.