Cardiology
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TAVR Beneficial for Patients With Severely Reduced Ejection Fraction
In patients with low-flow, low-gradient aortic stenosis and severe left ventricular dysfunction, transcatheter aortic valve replacement was associated with significant improvement in left ventricular ejection fraction and similar mortality compared to patients with milder left ventricular dysfunction.
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Late Mortality With Paclitaxel-Coated Balloons and Stents in Peripheral Arterial Disease
A newly published meta-analysis of randomized, controlled trials concerning paclitaxel-coated balloons and stents in femoral popliteal disease patients revealed a marked increase in all-cause death at two and five years.
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Early Extubation to Noninvasive Ventilation Does Not Reduce Time to Liberation From All Mechanical Ventilation
In this multicenter, randomized, open-label trial of patients who failed a spontaneous breathing trial, those who were extubated to noninvasive ventilation did not have a shorter time to liberation from any form of mechanical ventilation compared to those who were randomized to protocolized standard weaning.
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Thiamine for Septic Shock: Is There a Benefit?
Based on a retrospective review, septic shock patients who were administered thiamine within 24 hours of admission showed improved lactate clearance and reduced 28-day mortality.
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Liberal Oxygen Therapy in the ICU: Time to Change Practice?
Over the last decade, more clinical studies have shown adverse effects of hyperoxia in different patient populations and its association with increased mortality. In a meta-analysis, investigators synthesized data from 25 randomized, controlled trials comparing a liberal oxygen approach to a conservative approach. They included thousands of patients with sepsis, critical illness, stroke, trauma, myocardial infarction, cardiac arrest, and emergency surgery. The authors found that liberal oxygen therapy was associated with increased in-hospital mortality, 30-day mortality, and mortality at longest follow-up. Read on to learn more details about specific subgroups relevant to ICU practice and to see a review of the current data on oxygen therapy in these patients.
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A ‘Detective’ Diagnosis
The ECG in the figure was obtained from a 40-year-old man. Without the benefit of any history, how might one interpret this tracing? Is there evidence of an acute coronary syndrome? Is there a common diagnosis that potentially explains all the findings?
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Rifamycin Delayed-Release Tablets (Aemcolo)
Rifamycin is indicated for the treatment of traveler's diarrhea caused by noninvasive strains of Escherichia coli in adults.
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Patients Need to Rethink the ‘Quality’ in Healthcare
Increasingly, patient satisfaction is an important and commonly used surrogate marker for healthcare quality. Further, reimbursement to physicians may be based on patient satisfaction as a “quality” metric. But the evidence linking a patient’s subjective sense of satisfaction and the actual delivery of quality care remains tenuous.
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Healthcare-Associated Infections: Better, But Not There Yet
One-day prevalence studies demonstrated that there was a 16% reduction in the risk of healthcare-associated infections from 2011 to 2015.
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Factors Associated With Urinary Tract Infections Caused by Multidrug-Resistant Gram-Negative Bacteria
The authors of a multicenter, retrospective, cohort study from southern and eastern Europe identified predictive factors for multidrug-resistant complicated urinary tract infections.