Internal Medicine
RSSArticles
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Prediction of Survival After Cardiac Arrest Using Pupillometry
Automated infrared pupillometry holds promise as a quantitative, reproducible measure that aids in determining neurological prognosis after cardiac arrest and coma.
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Distinguishing Ischemic from Non-ischemic Cardiomyopathy Clinically
SYNOPSIS: This cardiac catheterization-based study of patients with newly diagnosed reduced left ventricular ejection fraction of unknown etiology showed that 15% had ischemic cardiomyopathy and they could be identified by clinical characteristics and an ECG-based risk score.
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B-type Natriuretic Peptide Is Less Useful in Elderly Patients with Dyspnea
SYNOPSIS: Among patients ≥ 80 years of age presenting with acute dyspnea, B-type natriuretic peptide level was not useful for differentiating cardiac vs. respiratory etiologies when added to a model of clinical predictors.
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Sepsis Management: What We Think We Know
SYNOPSIS: In the Protocolized Resuscitation in Sepsis Meta-Analysis (PRISM), 3,723 patients’ outcomes from the ProCESS, ARISE, and ProMISe randomized, controlled trials of early goal-directed therapy (EGDT) were evaluated. EGDT did not result in better outcomes than usual care and was associated with higher costs. The authors of a second study looked at outcomes of 49,331 patients with sepsis treated in New York from April 2014 to June 2016. More rapid completion of the three-hour sepsis bundle and antibiotic administration (but not rapid bolus administration of IV fluids) was associated with reduced in-hospital mortality.
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Dual Antibiotic Therapy Is Not Routinely Necessary for Uncomplicated Cellulitis
SYNOPSIS: A randomized, multicenter, placebo-controlled clinical trial that enrolled patients presenting to emergency departments with uncomplicated cellulitis found the addition of trimethoprim-sulfamethoxazole to cephalexin did not lead to better outcomes.
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Does Dexmedetomidine Improve Patient Outcomes in Sepsis?
In patients with sepsis requiring mechanical ventilation, use of dexmedetomidine compared with no dexmedetomidine did not result in an improvement in 28-day mortality or ventilator-free days.
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Resilience in the ICU: A Valuable Asset for Families
Interventions that teach resilience may improve family members’ experiences in the ICU.
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Management of Pulmonary Embolism in the ICU
Small, low-risk pulmonary embolism can be treated as an outpatient procedure or with heparin infusion alone, but higher-risk pulmonary embolism cases are managed properly in an ICU. With the introduction of newer modalities of treatment, appropriate risk stratification and the choice of treatment are increasingly complex.
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Going Wireless: Combining the Subcutaneous ICD With a Leadless Pacemaker
A system incorporating an entirely subcutaneous implantable cardioverter defibrillator that can command a novel leadless anti-tachycardia pacemaker unidirectionally showed success and promise in an early, short-term animal trial.
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Alcohol Septal Ablation in Younger HCM Patients: Should We Relax Guidelines?
Current guidelines recommend surgical myectomy over septal ablation for younger hypertrophic cardiomyopathy patients. A new study bridges part of the data gap, showing safety and efficacy of the procedure in young patients.