Critical Care
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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). -
Surviving Sepsis Campaign Guidelines Bundle: Studying How Improved Compliance Might Affect Outcomes
Improved compliance with the Surviving Sepsis Campaign guidelines bundle was associated with a non-statistically significant decrease in the in-hospital mortality of severe sepsis patients.
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The ABCs of In-hospital Cardiac Arrest
In this large, propensity-matched cohort study of patients who experienced an in-hospital cardiac arrest, patients who underwent endotracheal intubation had worse survival to hospital discharge than patients who were not intubated.
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The Clinical Utility of Measuring Dead Space Ventilation in Critical Illness
Here are some of the technologic and physiologic aspects of capnography as they relate to dead space ventilation and their application in the management of critically ill patients.
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Troponin Highly Prognostic in Decompensated Heart Failure with Preserved Ejection Fraction
SYNOPSIS: Among patients with acute decompensated heart failure and preserved ejection fraction, elevated troponin is associated with worse in-hospital outcomes and long-term survival, independent of other predictors.
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NOACs in Patients Requiring Anticoagulation Post-PCI
SYNOPSIS: The PIONEER study of atrial fibrillation patients post-percutaneous coronary intervention showed that regimens of clopidogrel plus reduced-dose regimens of rivaroxaban demonstrated lower bleeding and similar rates of stroke and adverse cardiac events compared with traditional warfarin triple therapy.
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A New Risk Score for Stroke in Atrial Fibrillation
SYNOPSIS: A new, simpler score for stroke risk prediction in atrial fibrillation patients uses biomarkers to supplant many clinical variables and outperforms the CHA2DS2-VASc score in two large cohorts.
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Antibiotic Treatment in Community-acquired Pneumonia
SYNOPSIS: In patients with newly diagnosed community-acquired pneumonia, basing the duration of antibiotic treatment on clinical stability criteria led to a significant reduction in duration of antibiotic treatment without an increased risk of adverse outcomes.
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Discharge Antibiotic Prescriptions Often Are Inappropriate with Regard to Choice, Dose, Duration
SYNOPSIS: Seventy percent of discharge antibiotic prescriptions are inappropriate.
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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.