Critical Care
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Is Exposure to Arterial Hyperoxia During Critical Illness Dangerous?
Exposure to severe hyperoxia during critical illness is associated positively with increased ICU and hospital mortality and associated negatively with ventilator-free days.
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Predicting Electrical Cardioversion Failure
A study of the 30-day success rate of electrical cardioversion of acute atrial fibrillation revealed five clinical predictors of recurrence. These were combined into a risk score that could be useful to avoid unnecessary cardioversions in the acute setting.
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Tolvaptan Fails to Improve Dyspnea in Acute Heart Failure
In patients hospitalized for acute heart failure, adding tolvaptan to furosemide lead to increased weight and fluid loss, but did not improve dyspnea at 24 hours.
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Restricting Fluoroquinolone Use Reduces CDI More Than Infection Control Methods
An observational study from England showed that restricting fluoroquinolone use reduced incidence of Clostridium difficile infection more than would be predicted by improved infection control methods alone.
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Risk Factors for Hospital Readmissions Ending in Death or Transition to Hospice
In this retrospective cohort study, multiple factors were identified during initial hospitalization, including sepsis and shock, that were associated with a hospital readmission within 30 days resulting in death or transition to hospice. Infection was a frequent cause for readmissions that ended in death.
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Studying Surrogate Responses Can Improve Communication in Chronic Critical Illness
Qualitative analysis of audio-recorded structured meetings for patients with chronic critical illness revealed six categories of responses that clinicians can use to guide communication.
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Muscle Weakness and Acute Respiratory Distress Syndrome: What Happens After the ICU?
Although increased strength at hospital discharge is associated with improved five-year survival in acute respiratory distress syndrome survivors, weakness at discharge, whether resolving or persistent, is associated with worse subsequent survival.
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2016 Surviving Sepsis Guidelines Update
All ICU clinicians need to review these guidelines, compare them with their current practices, and develop plans for implementation in the near future.
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Study Challenges Orthodoxy of IV Hydration for Prevention of Contrast Nephropathy
SYNOPSIS: This trial randomized 660 patients with chronic kidney disease and a planned procedure requiring intravascular iodinated contrast to prophylactic hydration or to no hydration. No hydration was found to be non-inferior for prevention of contrast-induced nephropathy and saved significant costs.
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Clindamycin Improves Outcomes in Necrotizing Fasciitis due to Group A Streptococcus
SYNOPSIS: Using a murine model of necrotizing fasciitis, investigators determined that clindamycin inhibits key virulence factors of Group A Streptococcus, and should be given as soon as possible and at high doses to reach levels above MIC in affected tissues.