Hospital Medicine Alert – April 1, 2014
April 1, 2014
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Warfarin may decrease morbidity and mortality in patients with kidney disease and atrial fibrillation after MI
Patients with chronic kidney disease, acute myocardial infarction and atrial fibrillation and treated with warfarin had a lower risk for death, MI and ischemic stroke without a higher risk of bleeding. -
Prognosis of Ventricular Fibrillation in Acute Myocardial Infarction
At this time, ventricular fibrillation (VF) early after acute myocardial infarction (MI) is not an indication alone for an implantable cardioverter-defibrillator (ICD) therapy. However, there is concern that despite the efficacy of mechanical and pharmacological therapy for acute MI, the risk of subsequent sudden cardiac death (SCD) in patients with VF complicating acute MI may be higher and the guidelines should be revisited. -
Mechanical Chest Compressions in CPR
Effective cardiopulmonary resuscitation (CPR) is partly dependent on the adequacy of manual chest compressions, but they are limited by interruptions and less than ideal conditions such as during transport. Mechanical chest compression devices have been developed that improve organ perfusion vs manual compressions in experimental studies, but there is little evidence of their clinical effectiveness and safety compared to manual compressions. -
The Concept of Healthcare-Associated Pneumonia Is Not Accurate for Predicting Antibiotic Resistant Pathogens
A systematic review and meta-analysis found that the healthcare-associated pneumonia concept was based on low-quality evidence confounded by publication bias and does not accurately identify antibiotic-resistant pathogens. -
An Evidence-Based Extubation Bundle Improved Care Outcomes in Mechanically Ventilated Brain-Injured Patients
Implementation of an evidence-based extubation-readiness bundle was associated with a decrease in mechanical ventilation days and pneumonia in brain-injured patients.