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Category Archives: Pulmonary and Critical Care
Machines better for CPR
This meta-analysis of 12 studies of out-of-hospital cardiac arrest found that machine-delivered CPR was associated with ~1.5 times the odds of return of spontaneous circulation compared to human CPR. This may also be true for in-hospital arrest but needs further … Continue reading
Posted in Cardiology, Pulmonary and Critical Care
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Following the pulmonary nodule
New updated guidelines provide guidance for what to do when a solitary pulmonary nodule is discovered on imaging. Among the recommendations: Obtain prior imaging; stability over 2 years does not require any further follow up. If no prior imaging for … Continue reading
Posted in Pulmonary and Critical Care
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Statins for sepsis
This randomized trial of 250 patients with sepsis, who were randomized to 14 days of statin or placebo, found no difference in serum markers of inflammation, organ dysfunction scores or morality between the groups. However, they did find that among … Continue reading
Posted in ID, Pulmonary and Critical Care
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Pneumococcal pneumonia still bad news
This cohort from the VA found those confirmed with pneumococcal pneumonia had a 12% 1 month mortality, and a 10 year mortality rate of~30%, which is higher than age-matched expectations. The prognosis was worse with bacteremic disease, and with higher … Continue reading
Posted in ID, Pulmonary and Critical Care
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Survival after discharge after in-hospital cardiac arrest
This large cohort of patients age>65 who survived in-hospital cardiac arrest found that 1 year after discharge, 59% were still alive, and 34% had not been readmitted to the hospital. Both mortality and readmission rates were substantially affected by the … Continue reading
Posted in Neurology, Pulmonary and Critical Care
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Family presence during CPR
In this trial of out-of-hospital cardiac arrest, families were randomized to be offered to watch CPR, or not offered. CPR was witnessed by 79% of the intervention families, versus 43% of the control families. The frequency of PTSD symptoms, anxiety, … Continue reading
Posted in Pulmonary and Critical Care
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Effect of delirium in critically ill
This meta-analysis of critically ill patients found significantly worse outcomes in those that experience delirium compared to those that do not, including higher mortality, more complications, longer vent duration, and longer ICU and hospital LOS (abstract). Continued efforts for prevention … Continue reading
Posted in Neurology, Pulmonary and Critical Care
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Mild therapeutic hypothermia after cardiac arrest
This meta-analysis found that mild therapeutic hypothermia after cardiac arrest is both safe and effective and should be standard practice (abstract).
Posted in Cardiology, Pulmonary and Critical Care
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Updated guidelines from surviving sepsis campaign
The Surviving Sepsis Campaign guidelines have been updated. Some of the highlights include (abstract): Initial fluids with crystalloids at 30cc/kg, with goal in first 6 hours of CVP 8-12mmHg, MAP>65 mmHg, and urine output >0.5cc/kg/hr; Antibiotics within 1 hour No … Continue reading
Posted in ID, Pulmonary and Critical Care
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Noninvasive ventilation for acute COPD
In this large retrospective analysis of patients hospitalized with acute COPD exacerbations with respiratory failure, the use of noninvasive ventilation increased from 14% to 16% from 2006 to 2008, but variation in use between hospitals was great (ranging from 0 … Continue reading
Posted in Pulmonary and Critical Care
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