Hospital Medicine Alert – May 1, 2012
May 1, 2012
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Postoperative Complications in Patients with Obstructive Sleep Apnea
More than half of patients undergoing non-cardiac surgery and polysomnography had obstructive sleep apnea, which was associated with an increased risk of perioperative complications, including hypoxemia, ICU transfer, and prolonged length of stay. -
Myocardial Infarction Symptom Presentation
Timely recognition and treatment of myocardial infarction (MI) are crucial if we are to achieve optimal outcomes for our patients. Silent ischemia, or the absence of classical symptoms of ischemia, may delay the diagnosis. -
Appropriate Dosage of Vancomycin in End-Stage Renal Disease Patients Requiring Intermittent Hemodialysis
Infection is the second leading cause of death in hemodialysis patients, with mortality rates ranging from 12-36% in this vulnerable population. -
Neuroprognostication in Patients Receiving Therapeutic Hypothermia Following Cardiac Arrest
Although current guidelines recommend delaying neuroprognostication during therapeutic hypothermia following resuscitation from cardiac arrest, this review of 55 consecutive patients so managed found that a "poor prognosis" designation was arrived at during the hypothermia period in most of them, including six patients who were eventually discharged with a favorable neurologic outlook. -
Respiratory Arrest: An Adverse Effect of Polymyxins
Two ICU patients experienced respiratory arrest while receiving polymyxin. Given the recent resurgence of use of this antibiotic and its close relative colistin to treat gram-negative infections resistant to newer agents, clinicians should be aware of this infrequent but long-known and potentially fatal adverse effect.