Review: Incidence, prevalence, and management of MRSA bacteremia

22Aug
2017

Guideline: Prevention of acute kidney injury and protection of renal function in the intensive care unit

22Aug
2017

Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017 – Intensive Care Medicine (free)

Expert opinion of the Working Group on Prevention, AKI section, European Society of Intensive Care Medicine

 

Study: Risk of Arterial Thromboembolism in Patients With Cancer

22Aug
2017

Study: Delirium and Benzodiazepines Associated With Prolonged ICU Stay in Critically Ill Infants and Young Children

22Aug
2017

Delirium and Benzodiazepines Associated With Prolonged ICU Stay in Critically Ill Infants and Young Children – Critical Care Medicine (free)

Editorial: Benzodiazepines and Delirium in the Young and Old: Truth Be Told or Still Not Sold? (free)

“Benzodiazepine exposure is associated with the development and longer duration of delirium, and lower likelihood of ICU discharge”.

 

Review: Oncological patients in the intensive care unit

22Aug
2017

Guideline: Safe Medication Use in the ICU

21Aug
2017

Meta-analysis: Acute Kidney Injury After Computed Tomography

21Aug
2017

Acute Kidney Injury After Computed Tomography: A Meta-analysis – Annals of Emergency Medicine (link to abstract – $ for full-text)

Commentary: When kidneys are injured, CT contrast isn’t the culprit – Health Imaging (free)

Related article: Risk of Acute Kidney Injury After Intravenous Contrast Media Administration – Annals of Emergency Medicine (free)

Source: Hospital Medicine Virtual Journal Club

Compared with noncontrast CT, contrast-enhanced CT was not significantly associated with either acute kidney injury, need for renal replacement therapy, or all-cause mortality.

 

Review: Postoperative pulmonary complications

21Aug
2017

Coma After Acute Head Injury

17Aug
2017

Standard of Care in Critically Ill Adult Patients With Atypical Hemolytic Uremic Syndrome

17Aug
2017

Decompensated Heart Failure

17Aug
2017

Comparison of early versus late initiation of renal replacement therapy for acute kidney injury in critically ill patients

17Aug
2017

A comparison of early versus late initiation of renal replacement therapy for acute kidney injury in critically ill patients: an updated systematic review and meta-analysis of randomized controlled trials – BMC Nephrology (free)

Source: Critical Care Reviews Newsletter

Early initiation of RRT in critically ill patients did not result in reduced mortality, change in renal function recovery, dependence, duration of RRT, renal recovery time, mechanical ventilation time or complications.

 

Five-Year Outcomes after On-Pump and Off-Pump Coronary-Artery Bypass

16Aug
2017

Effect of scheduled second-look endoscopy on peptic ulcer bleeding

16Aug
2017

Effect of scheduled second-look endoscopy on peptic ulcer bleeding: a prospective randomized multicenter trial – Gastrointestinal Endoscopy (link to abstract – $ for full-text)

Source: No Benefit of Second-Look Endoscopy After Endoscopic Hemostasis – Journal Watch ($)

“A single EGD with endoscopic hemostasis is not inferior to scheduled second-look endoscopy in terms of reduction in rebleeding rate of peptic ulcer bleeding. Repeat endoscopy would be helpful in the patients with unsatisfactory initial endoscopic hemostasis, use of NSAIDs, and larger amounts of transfused blood”

 

Role of nutrition support in adult cardiac surgery

16Aug
2017

Syphilis in the ED: Presentations, Diagnosis, and Management of the Great Imitator

16Aug
2017

Working up high: Hospitalist practice is different at altitude

16Aug
2017

Sepsis in the burn patient

15Aug
2017

The effect of high-flow nasal cannula in reducing the mortality and the rate of endotracheal intubation

15Aug
2017

Eliminating CK–MB Testing in Suspected Acute Coronary Syndrome

15Aug
2017

Review: Lyme Disease: Emergency Department Considerations

11Aug
2017

Review: General Care of the Pregnant Patient in the Intensive Care Unit

11Aug
2017

Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients

11Aug
2017

Mechanical Thrombectomy Outcomes With and Without Intravenous Thrombolysis in Stroke Patients: A Meta-Analysis – Stroke (link to abstract – $ for full-text)

Commentary: Better outcomes seen in patients who received IV thrombolysis before thrombectomy – ACP Hospitalist (free)

“The results support current guideline recommendations to give intravenous thrombolysis to eligible patients even if they are being considered for mechanical thrombectomy, according to the meta-analysis authors” (from ACP)

 

Hyperventilation Therapy for Control of Posttraumatic Intracranial Hypertension

11Aug
2017

Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy

11Aug
2017

Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy – Journal of Intensive Care (free)

“it is unlikely that a single biomarker serve as an effective diagnosis tool”

 

Seasonal influenza: managing cases in critical care units

11Aug
2017

Suicide Prevention in an Emergency Department Population

10Aug
2017

Suicide Prevention in an Emergency Department Population: The ED-SAFE Study – JAMA Psychiatry (link to abstract – Free Full Text PDF via @unpaywall)

Commentaries: Intervention Phone Calls May Save The Lives Of Suicidal Patients, Reduce New Attempts, Trial Finds – Medical Daily (free) AND National study shows interventions like telephone calls can reduce suicides – EurekAlert (free) AND Intervention Curbs New Suicide Attempts in At-Risk ED Patients – Medscape (free registration required)

Source: Psychiatry Research Review

“Patients who received a multifaceted intervention that included follow-up telephone calls resulted in a 30 percent reduction in future suicide attempts” (from Medical Daily)

 

Surgical Guidelines for Perioperative Management of Older Adults

10Aug
2017

Ventilation in Extremely Preterm Infants and Respiratory Function at 8 Years

10Aug
2017

Continuous glucose monitoring in the ICU: clinical considerations and consensus

10Aug
2017

Alternatives to hospital admission for people aged over 65 years

9Aug
2017

A systematic review to identify and assess the effectiveness of alternatives for people over the age of 65 who are at risk of potentially avoidable hospital admission – BMJ Open (free) (RT @NIHR_DC)

Alternatives to hospital admission for people aged over 65 years can be safe and reduce costs across a range of acute and chronic conditions.

 

Clinical management of hypercholesterolaemia in patients with acute coronary syndromes

9Aug
2017

Acute mesenteric ischemia: guidelines

9Aug
2017

Advances in the diagnosis of pneumonia in children

7Aug
2017

Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome

7Aug
2017

Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta-analysis of randomised trials – The Lancet (link to abstract – $ for full-text)

Commentary: Optimal Timing of an Invasive Strategy in NSTE-ACS Patients – American College of Cardiology, Latest in Cardiology (free)

An early invasive strategy does not reduce mortality compared with a delayed invasive strategy in most patients with NSTE-ACS, but seems to reduce mortality in high-risk patients.

 

Mechanical clot removal for stroke reduces disability at two years

3Aug
2017

Mechanical clot removal for stroke reduces disability at two years – NIHR Signal (free)

“Mechanical thrombectomy within six hours of stroke onset provides a sustained reduction of disability for patients” (RT @NIHR_DC see Tweet)

 

Discover and defeat your diagnostic errors

3Aug
2017

Discover and defeat your diagnostic errors – ACP Internist (free) (RT @acpinternist  see Tweet)

“Experts explain the causes and solutions for common mistakes in diagnosis”.

 

Peri-operative myocardial injury and infarction in patients undergoing coronary artery bypass graft surgery

3Aug
2017

Resuscitation medicine – Singapore Guidelines

3Aug
2017

Predicting Risk of Serious Bacterial Infections in Febrile Children in the Emergency Department

1Aug
2017

Resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients

1Aug
2017

A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients – World Journal of Emergency Surgery (free)

This meta-analysis, mainly from observational studies and including 1276 patients, suggests a positive effect of REBOA on mortality among non-compressible torso hemorrhage patients.

 

Efficacy of corticosteroid treatment for severe community-acquired pneumonia: A meta-analysis

1Aug
2017

Efficacy of corticosteroid treatment for severe community-acquired pneumonia: A meta-analysis – American Journal of Emergency Medicine (link to abstract – $ for full-text)

Source: More Evidence That Steroids Are Beneficial in Community-Acquired Pneumonia – Journal Watch ($)

In this meta-analysis of randomized controlled trials in patients with severe community-acquired pneumonia, corticosteroid treatment was associated with reduced in-hospital mortality and length of hospital stay.

 

Targeted Temperature Management for 48 vs 24 Hours and Neurologic Outcome After Out-of-Hospital Cardiac Arrest

1Aug
2017

Diagnostic Stewardship – Leveraging the Laboratory to Improve Antimicrobial Use

1Aug
2017

Diagnostic Stewardship – Leveraging the Laboratory to Improve Antimicrobial Use – JAMA (free)

“This Viewpoint discusses the potential benefits and harms of diagnostic stewardship – modifying the ordering, performance, and reporting of diagnostic tests to improve antimicrobial use”

 

A ‘perfect storm’ superbug: How an invasive fungus got health officials’ attention

1Aug
2017

Clinical practice guideline for the management of ARDS

1Aug
2017

Laparoscopy in Blunt Abdominal Trauma: for Whom? When?and Why?

1Aug
2017

Percutaneous short-term active mechanical support devices in cardiogenic shock

28Jul
2017

Percutaneous short-term active mechanical support devices in cardiogenic shock: a systematic review and collaborative meta-analysis of randomized trials – European Heart Journal (link to abstract – $ for full-text))

Commentary with 10 key points to remember: Mechanical Support Devices in Cardiogenic Shock – American College of Cardiology, Latest in Cardiology (free)

“Based on contemporary evidence, it appears prudent to restrict the use of active percutaneous MCS to selected patients” (from Latest in Cardiology)

“Results of this collaborative meta-analysis do not support the unselected use of active MCS patients with CS complicating AMI” (from original article)

 

Approach to Patient with Sarcoidosis in the ED setting

27Jul
2017

Update in Management of Severe Hypoxemic Respiratory Failure – Chest

27Jul
2017

Guideline: Damage control resuscitation in patients with severe traumatic hemorrhage

25Jul
2017

Guideline: Operative fixation of rib fractures after blunt trauma

25Jul
2017

Updates in Management of Hyperkalemia

25Jul
2017

The Diagnosis and Treatment of Hemoptysis

25Jul
2017

Cardiocerebral and cardiopulmonary resuscitation – 2017 update

25Jul
2017

Review: Update on pediatric sepsis

25Jul
2017

Management of elderly patients with a non-ST-segment-elevation acute coronary syndrome

25Jul
2017

European Society of Cardiology Clinical Practice Guidelines Summary Cards

25Jul
2017

Review: Organ dysfunction, injury and failure in acute heart failure

24Jul
2017

Acute Aortic Syndromes: Diagnosis and Management

23Jul
2017

Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults

23Jul
2017

Video Laryngoscopy for Endotracheal Intubation of Critically Ill Adults: A Systemic Review and Meta-Analysis – Chest (free)

Source: Video Laryngoscopy Does Not Improve First-Pass Success in ICU Patients – Journal Watch ($)

“The VL technique did not increase the first-attempt success rate during EI in ICU patients compared with DL. These findings do not support routine use of VL in ICU patients”.

 

A focus on treating fever does not improve survival in sepsis

22Jul
2017

Short review: Subarachnoid Hemorrhage

21Jul
2017

Review: Optimizing diagnostic testing for venous thromboembolism

21Jul
2017

Antiplatelet Regimen for Patients With Breakthrough Strokes While on Aspirin

21Jul
2017

Antiplatelet Regimen for Patients With Breakthrough Strokes While on Aspirin: A Systematic Review and Meta-Analysis – Stroke (link to abstract – $ for full-text)

Commentary: Adjusting Antiplatelet Regimen Could Decrease Risk For Stroke Patients on Aspirin Monotherapy – American College of Cardiology, Latest in Cardiology (free)

Meta-analysis of cohort studies: in patients who experienced an ischemic stroke or transient ischemic attack while on aspirin monotherapy, the addition of or a switch to another antiplatelet agent, versus aspirin monotherapy, was associated with a 32 percent reduction in the risk of major adverse cardiovascular events (HR 0.68; 0.54–0.85) and 30 percent reduction in recurrent strokes (HR, 0.70; 0.54–0.92). Additional randomized trials would better clarify the best antiplatet regimen for these patients.

 

The Effects of Public Access Defibrillation on Survival After Out-of-Hospital Cardiac Arrest

21Jul
2017

An emergency department protocol to restore circulation doesn’t improve outcomes in septic shock

21Jul
2017

Efficacy and Safety of Spironolactone in Acute Heart Failure

21Jul
2017

Rhabdomyolysis & Exertional Heat Stroke

20Jul
2017

Emergency Management of Pediatric Seizures

18Jul
2017

Guideline: The management of intra-abdominal infections from a global perspective

17Jul
2017

High-flow nasal cannula oxygen therapy is superior to conventional oxygen therapy

17Jul
2017

Studies suggest apneic oxygenation reduces hypoxemia during emergency intubation

17Jul
2017

Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of COPD

16Jul
2017

Non-invasive ventilation for the management of acute hypercapnic respiratory failure due to exacerbation of chronic obstructive pulmonary disease – Cochrane Library (free)

NIV reduces mortality and endotracheal intubation in patients with acute hypercapnic respiratory failure secondary to an acute exacerbation COPD.

 

Guideline: Nutrition Support Therapy in the Pediatric Critically Ill Patient

16Jul
2017

The future of mechanical ventilation: lessons from the present and the past

13Jul
2017

Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke

12Jul
2017

Blood pressure and in-hospital outcomes in patients presenting with ischaemic stroke – European Heart Journal (link to abstract – $ for full-text)

Commentary: Blood Pressure and Outcomes After Ischemic Stroke – American College of Cardiology, Latest in Cardiology (free)

Related article: Editorial: Blood Pressure in Acute Stroke Still No Answer for Management – Stroke (free PDF)

Observational analysis of over 300.000 patients suggests a J-shaped, or U-shaped relationships between BP and outcomes (both lower and higher BP levels detrimental). Among patients submitted to thrombolytic therapy, there were fewer complications with lower blood pressure.

 

Advances in the causes and management of community acquired pneumonia in adults

12Jul
2017

Meta-analysis: Dual Versus Triple Antithrombotic Therapy in Patients Undergoing Percutaneous Coronary Intervention

11Jul
2017

Meta-analysis: Safety and Efficacy of Dual Versus Triple Antithrombotic Therapy in Patients Undergoing Percutaneous Coronary Intervention – American Journal of Medicine (link to abstract – $ for full-text)

Source: EvidenceAlerts (free resource to find articles of interest)

“In patients receiving anticoagulant therapy, a strategy of single antiplatelet therapy confers a benefit of less major bleeding with no difference in all-cause mortality, cardiovascular mortality, major adverse cardiac events, myocardial infarction, stent thrombosis, or thromboembolic event rate compared with dual antiplatelet therapy”.

 

Post-Surgical Complications

11Jul
2017

Post-Surgical Complications – emDocs (free)

Practical review of this common problem in the emergency department.

 

Direct oral anticoagulants for treatment of Heparin-induced Thrombocytopenia

9Jul
2017

Direct oral anticoagulants for treatment of HIT: update of Hamilton experience and literature review – Blood (link to abstract – $ for full-text)

Source: Direct Oral Anticoagulants for Heparin-Induced Thrombocytopenia – Journal Watch ($)

This literature review and observational study suggest direct oral anticoagulants (rivaroxaban, apixaban, dabigatran) are safe and effective for the treatment of Heparin-induced Thrombocytopenia.

 

Guidelines for the investigation and management sepsis in pregnancy

7Jul
2017

Peri-operative blood management

7Jul
2017

The use of high-frequency ventilation during general anaesthesia

7Jul
2017

Common ED Medication Errors: Polypharmacy

4Jul
2017

The practice of tracheostomy decannulation

3Jul
2017

Direct oral anticoagulants in patients with chronic kidney disease

3Jul
2017

Perioperative Management of Neurological Conditions

3Jul
2017

Treatment of severe alcoholic hepatitis

3Jul
2017

CABG vs DES for Non–ST-Elevation Acute Coronary Syndrome and left main or multivessel CAD

29Jun
2017

Comparison of Outcome of Coronary Artery Bypass Grafting Versus Drug-Eluting Stent Implantation for Non–ST-Elevation Acute Coronary Syndrome – The American Journal of Cardiology (link to abstract – $ for full-text)

Source: EvidenceAlerts

In patients with Non–ST-Elevation Acute Coronary Syndrome and left main or multivessel CAD, CABG significantly reduced the risk of death from any causes, myocardial infarction, or stroke compared with PCI with drug-eluting stents

 

Recognizing Sepsis as a Global Health Priority

29Jun
2017

Cardiovascular Testing and Clinical Outcomes in Emergency Department Patients With Chest Pain

28Jun
2017

Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates

26Jun
2017

Viewpoint: Contact Precautions for Endemic MRSA and VRE: Time to Retire Legal Mandates – JAMA (free)

“Contact precautions are easy to use w a single patient, but burdensome when applied to an entire hospital” (RT @JAMA_current see Tweet)

This viewpoint suggests a more selective use of contact precautions for the control of endemic pathogens.

 

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection

26Jun
2017

Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis – Gastroenterology (free)

Source: EvidenceAlerts (free resource to find articles of interest)

In this meta-analysis including 19 randomized trials, probiotics given within 2 days of the first antibiotic dose (more effective than if started later) reduced the risk of Clostridium difficile infection (CDI) by >50% in hospitalized adults. 1 case of CDI would be prevented for every 23−144 patients treated with probiotics when antibiotics are started. “There was no convincing evidence of superior efficacy for any of the tested probiotic formulations, delivery methods (drink or capsule), or probiotic doses”.

 

Effect of Nebulized Hypertonic Saline Treatment in Emergency Departments on the Hospitalization Rate for Acute Bronchiolitis

25Jun
2017

Targeted temperature management in the ICU

23Jun
2017

Time-to-Furosemide Treatment and Mortality in Acute Heart Failure

23Jun
2017

Time-to-Furosemide Treatment and Mortality in Patients Hospitalized With Acute Heart Failure – Journal of the American College of Cardiology (link to abstract – $ for full-text)

Commentary: Door-to-Furosemide Time in Acute Heart Failure – American College of Cardiology, Latest in Cardiology (free)

“God help us if this sort of observational data leads to “door to furosemide time” being adopted as a quality measure” (RT @adamcifu see Tweet)

 

Guideline summary: Consensus on Surgical Treatment of Infective Endocarditis

23Jun
2017

Head Positioning in Acute Stroke

23Jun
2017

Continuous positive airway pressure for children with undifferentiated respiratory distress

23Jun
2017
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