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Authors: McAuley DF et al., N Engl J Med 2014 Sep 30; Another randomized study showed no benefit for ventilator-free days or 28-day mortality in patients with acute respiratory distress syndrome. Despite promising findings in observational studies, results of a large randomized, controlled trial recently demonstrated no benefit of statins in patients with acute respiratory […]
Read MoreThis is for our providers who practice in the critical care unit. Authors: Harvey SE et al., N Engl J Med 2014 Oct 1; Patients in the intensive care unit had similar outcomes, whether they were fed enterally or parenterally. Debate is ongoing over the appropriate way to deliver early nutritional support to critically ill […]
Read MoreAuthors: Smekal D et al., Resuscitation 2014 Sep 29; Autopsies revealed chest-compression–related injuries, mostly rib fractures, in more than 75% of patients. To compare injuries from manual versus mechanical chest compressions, researchers in Sweden conducted a prospective multicenter study of 222 adults who had autopsies after unsuccessful cardiopulmonary resuscitation (CPR) following nontraumatic cardiac arrest. Overall, […]
Read MoreAuthors: Levy MM et al., Crit Care Med 2014 Oct 1; An analysis of a large database shows a 25% relative mortality risk reduction in institutions with high versus low compliance with sepsis performance bundles. The Surviving Sepsis Campaign (SSC) has led to early identification and treatment of patients with sepsis. Using the SSC’s database, […]
Read MoreAuthors: Parnia S et al., Resuscitation 2014 Oct 6; Nearly 40% of 140 cardiac arrest survivors claimed memories from when they were in cardiac arrest. Awareness during anesthesia has been well described, but what about during cardiac arrest? Researchers performed a 4-year multicenter observational study involving a qualitative and quantitative interview of 140 post-cardiac arrest […]
Read MoreAuthors: Wadia S et al., Ann Emerg Med 2014 Oct 64:385 In a study of 60 children undergoing procedural sedation with ketamine, intraocular pressure increased only by a median of 3 mm Hg. Investigators evaluated ketamine’s effect on intraocular pressure in a prospective observational study of children aged 8–18 years undergoing procedural sedation at a […]
Read MoreThe percentage of patients reporting moderate to extreme pain two weeks after surgery has plummeted in the last decade thanks to better understanding of how different classes of pain medications work, a new survey found. Overall patient satisfaction with post-op pain meds has increased slightly, from 83 percent in 2003 to 87 percent this year, […]
Read MoreAuthors: Donzé JD et al., BMJ 2014 Sep 8; 349:g5334 Risk increases with severity of sepsis. Coronary artery disease is a risk factor for postoperative arterial thrombosis; male sex, older age, cancer history, and prior venous thrombosis are risk factors for postoperative venous thrombosis. However, whether systemic inflammation (which induces a hypercoagulable state) promotes risk […]
Read MoreAuthors: Gu WJ., Chest 2014 Sep 25; A meta-analysis finds no evidence of harm. Etomidate causes laboratory abnormalities, specifically, suppression of cortisol production. Prior authors have attempted to demonstrate corresponding patient harm (NEJM JW Emerg Med Jan 16 2014). A new meta-analysis of two randomized, controlled trials and 16 observational studies involving 5552 patients helps […]
Read MoreAuthors: Stiell IG et al., Circulation 2014 Sep 24; A large prehospital study found that survival was highest when chest compression depths were between 4.0 and 5.5 cm. In 2010, the American Heart Association (AHA) suggested an increase in the target depth of chest compressions to at least 5 cm. However, there have been no […]
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