Hospital Medicine Alert
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Bedside Ultrasound: Is It a Reliable Tool for Guiding Resuscitation in Patients with Undifferentiated Hypotension?
The use of bedside ultrasound has expanded tremendously over the last few decades. As it is readily available and relatively inexpensive, ultrasound provides the opportunity to examine hypotensive, critically ill patients, potentially leading to a faster, more accurate diagnosis.
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Sepsis Resuscitation and Mortality
The use of balanced salt solutions rather than isotonic saline or colloids may improve in-hospital mortality in patients admitted with septic shock.
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Ceftazidime-avibactam — Formulary Considerations
Ceftazidime-avibactam is a new beta-lactam/beta-lactamase inhibitor combination approved for the treatment of complicated intra-abdominal infections in combination with metronidazole, and complicated urinary tract infections, including pyelonephritis in patients with limited alternative treatment options.
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Idarucizumab Injection (Praxbind)
The FDA has approved the first reversal agent for a direct oral anticoagulant. Idarucizumab is a humanized monoclonal antibody fragment derived from an IgG1 isotype molecule. -
Optimal Beta-blocker Dose Post-MI
Beta-blocker therapy after acute myocardial infarction was retired as a hospital performance measure because its almost universal acceptance removed its discriminating value. However, it is well known that clinically used doses are significantly lower than those achieved in the randomized trials, establishing their mortality-reducing benefits.
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Can We Safely Discharge Patients on the Weekend?
ABSTRACT & COMMENTARY: The link between weekend discharge and 30- and 90-day readmission rates.
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Beta-blocker Dose More Important Than Heart Rate in Systolic Heart Failure
Beta-blockers reduce both morbidity and mortality in chronic heart failure with reduced ejection fraction.
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Acetaminophen for Fever in the ICU
SYNOPSIS: Seven hundred ICU patients with fever and known or suspected infection were randomly assigned to receive acetaminophen 1 g IV or placebo every 6 hours until ICU discharge, resolution of fever, cessation of antimicrobial therapy, or death. Early administration of acetaminophen did not affect number of ICU-free days.
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Clostridium difficile Infection — Back to the Future
SYNOPSIS: This study provides strong evidence that the diagnosis of Clostridium difficile infection (as opposed to colonization) should be made on the basis of evidence of toxin production, not the mere presence of the organism as detected by glutamate dehydrogenase testing or the presence of toxin genes.
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Efficacy and Safety of Very Early Mobilization After Onset of Acute Stroke
SYNOPSIS: The higher dose, very early (within 24 hours) mobilization protocol was associated with a reduction in the odds of a favorable outcome at 3 months after stroke occurrence.