A systematic review and meta-analysis found that the healthcare-associated pneumonia concept was based on low-quality evidence confounded by publication bias and does not accurately identify antibiotic-resistant pathogens.
Effective cardiopulmonary resuscitation (CPR) is partly dependent on the adequacy of manual chest compressions, but they are limited by interruptions and less than ideal conditions such as during transport. Mechanical chest compression devices have been developed that improve organ perfusion vs manual compressions in experimental studies, but there is little evidence of their clinical effectiveness and safety compared to manual compressions.
Patients with chronic kidney disease, acute myocardial infarction and atrial fibrillation and treated with warfarin had a lower risk for death, MI and ischemic stroke without a higher risk of bleeding.
There are several relatively new adjuvant treatments for patients with massive hemorrhage. Of these, TXA is most widely recommended. It is inexpensive and has been shown to reduce mortality when given within three hours of injury.
A new test, viscoelastic hemostatic assay, identifies the patient's stage of coagulability and fibrinogen status. The result of the test is a curve, which can help determine the need for fibrinogen, clotting factors, and platelets.
Massive transfusion is an independent predictor of increased mortality, increased infection rate, SIRS, andmulti-organ failure.
Complications of massive transfusion include acid/base derangement, electrolyte abnormalities (particularly hyperkalemia with rapid infusion), immune system changes, acute lung injury, and fluid overload.
The authors conclude that outpatient treatment with oral antibiotics is as safe and effective as initial hospitalization for intravenous therapy, at a lower cost and without decline in quality of life.
In a retrospective cohort study, elderly patients who were prescribed calcium-channel blockers (CCBs) with clarithromycin were at increased risk for developing acute kidney injury.