Hospital Medicine Alert
RSSArticles
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Does the Use of Saline vs Buffered Crystalloid Reduce Risk of Acute Kidney Injury in ICU?
The use of a buffered crystalloid compared with saline did not reduce the risk of acute kidney injury in patients receiving crystalloid fluid therapy in the ICU.
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Effects of a Rapid Response System Driven by Real-time Automated Clinical Alerts
The addition of an automated real-time clinical deterioration alert system to a rapid response system had marginal effects.
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Is Sodium Restriction Detrimental in Chronic Heart Failure?
In an observational study of outpatients with NYHA class II or III heart failure, dietary sodium restriction (< 2500 mg/day) was associated with increased risk of death or heart failure hospitalization.
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Fecal Microbiota Transplantation: Patients Need No Convincing
Relapsing and refractory Clostridium difficile infection has become a real challenge for clinicians and affected patients alike. Some patients wind up in a seemingly never-ending cycle of illness, gradual improvement, followed by a prolonged vancomycin taper, and eventual relapse.
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Blood Transfusion in Cardiac Disease Patients
An observational study confirms the hypothesis that ischemic heart disease patients may do better with higher hemoglobin levels as compared to ICU patients without heart disease.
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Early Chest CT Can Improve Treatment for Community-acquired Pneumonia
In patients with suspected community-acquired pneumonia, early chest CT significantly changed management decisions.
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The Opioids Just Keeping Coming
Most opioid prescriptions are continued after a patient overdoses accidentally. Those patients are also at risk for a recurrent overdose.
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Delay in Performing Endovascular Reperfusion Results in Worse Disability Outcomes
In the past year, multiple clinical trials have reported that intra-arterial endovascular reperfusion with mechanical clot extraction, using the SOLITAIRE stent retriever device and others, results in better neurological outcomes than treating patients with intravenous thrombolysis alone with TPA. There is still uncertainty regarding the maximum time window, and how important early intervention is as related to neurological recovery and long-term outcomes.
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Spironolactone for Resistant Hypertension
Resistant hypertension is common, and the choice of additional drug therapy in this condition is not clear.
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Clinicians Are Skeptical of Early Warning Systems for Sepsis
Severe sepsis is very common, with high morbidity and mortality. Early recognition and intervention improves mortality. However, the diagnosis may often be missed in early sepsis. An academic health system developed an electronic early warning and response system for sepsis in 2012, monitoring real time vital signs and laboratory data for hospitalized, non-ICU, acute care patients and notifying clinicians when specific criteria were met.