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Although age is a risk factor for morbidity and mortality with cardiac surgery, chronologic age does not always reflect biological age. Although frailty has been shown to predict falls, hospitalization, institutionalization, and mortality in geriatric populations in the community, it has not been systematically studied in patients undergoing surgery.
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This two-phase, prospective, multicenter study demonstrated that implementation of an intubation management protocol reduced the incidence of severe hypoxemia and cardiovascular collapse during endotracheal intubation when compared to standard practice, but did not improve other patient outcomes such as ICU mortality or duration of mechanical ventilation.
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In a prospective, observational study, > 50% of patients identified and treated for severe sepsis in the emergency department (ED) had negative cultures; 18% of patients had a noninfectious diagnosis that mimicked sepsis.
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The risk of relapse after effective therapy with plasma exchange for thrombotic thrombocytopenic purpura (TTP) has not been well-characterized. Among 376 patients with an initial episode of TTP treated with plasma exchange, overall survival was around 68%, with a survival of 78% among the subset with idiopathic TTP. Survival did not differ on those having a low (< 10%) ADAMTS13 level. Relapse was greater for those with a low ADAMTS13 level at the time of presentation.
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In this large retrospective cohort study of more than 100,000 patients in 112 hospitals, after correction for illness severity and other factors, daily rounds by a multidisciplinary care team were associated with lower mortality in the ICU, regardless of whether an intensivist model of physician staffing was in use.
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Consensus guidelines recommend the use of either dopamine or norepinephrine as first-line therapy for patients with shock, but recent observational evidence suggests norepinephrine may be associated with better outcomes.
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Intensive care practitioners are constantly faced with questions about their patients' hemodynamic issues, including the volume status, fluid responsiveness, and the need for vasopressors or inotropic support.
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In this issue: Fractures and bisphosphonate therapy, warfarin anticoagulation and influenza vaccine and cotrimoxazole, antiplatelet therapy with clopidogrel and aspirin, FDA Actions.
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