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October 2012 Briefing - Critical Care

October 2012 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for October 2012. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

FDA: Ameridose Issues Voluntary Recall of All Products

WEDNESDAY, Oct. 31 (HealthDay News) -- Ameridose, a Massachusetts-based manufacturer of sterile injectable products and oral syringes, is undergoing a voluntary recall of all unexpired products in circulation, according to an Oct. 31 news release issued by the U.S. Food and Drug Administration.

More Information (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm326361.htm )

Smoke-Free Workplace Laws Lead to Decline in MI Incidence

WEDNESDAY, Oct. 31 (HealthDay News) -- Following implementation of workplace smoke-free laws, the incidence of myocardial infarction (MI) decreased significantly in Olmsted County, Minn., according to a study published online Oct. 29 in the Archives of Internal Medicine.

Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1387590#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1387590 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1387587 )

U.S. Medicare Spending on Elderly Has Outpaced Canada's

TUESDAY, Oct. 30 (HealthDay News) -- U.S. Medicare spending on the elderly has grown nearly three times faster than its Canadian counterpart, according to a study published online Oct. 29 in the Archives of Internal Medicine.

Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1387588 )

Evidence-Based Practices to Prevent Peri-Op VTE Identified

TUESDAY, Oct. 30 (HealthDay News) -- Evidence-based practices to improve the consistency of venous thromboembolism (VTE) prophylaxis in the perioperative period have been identified, according to research published online in the November issue of the AORN Journal.

Abstract (http://www.aornjournal.org/article/S0001-2092(12)00771-5/abstract )Full Text (subscription or payment may be required) (http://www.aornjournal.org/article/S0001-2092(12)00771-5/fulltext )

Differences in Sepsis Care Identified in Europe, U.S.

FRIDAY, Oct. 26 (HealthDay News) -- Despite differences in processes of care and raw mortality for patients with severe sepsis and septic shock in the United States and Europe, after adjustment, mortality rates are similar, according to a study published online Oct. 26 in The Lancet Infectious Diseases.

Abstract (http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(12)70239-6/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(12)70239-6/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(12)70263-3/fulltext )

Sleep Apnea Linked to Less Severe Injury During Acute MI

THURSDAY, Oct. 25 (HealthDay News) -- During an acute non-fatal myocardial infarction (MI), patients with obstructive sleep apnea (OSA) have less severe cardiac injury, according to a study published in the October issue of Sleep and Breathing.

Abstract (http://link.springer.com/article/10.1007/s11325-012-0770-7 )Full Text (subscription or payment may be required) (http://link.springer.com/article/10.1007/s11325-012-0770-7 )

Worse Outcomes for Mother-Infant Pairs in Separate ICUs

WEDNESDAY, Oct. 24 (HealthDay News) -- Concurrent admission of a mother and her newborn to separate intensive care units (co-ICU) is associated with increased prevalence of mother-infant separation because of interfacility transfer, and with elevated mortality for both, according to a study published online Oct. 22 in CMAJ, the journal of the Canadian Medical Association.

Abstract (http://www.cmaj.ca/content/early/2012/10/22/cmaj.121283 )Full Text (http://www.cmaj.ca/content/early/2012/10/22/cmaj.121283.full.pdf+html )

Better Outcomes for Ventilation With Lower Tidal Volumes

TUESDAY, Oct. 23 (HealthDay News) -- Protective ventilation with lower tidal volumes is associated with better clinical outcomes in patients without acute respiratory distress syndrome (ARDS), according to a meta-analysis published in the Oct. 24 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1386591#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1386591 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1386595 )

Genuine Very Large Effects in Trials Rare in Medicine

TUESDAY, Oct. 23 (HealthDay News) -- Large treatment effects are most likely to be found in small studies, with the effect diminishing with additional trials, according to research published in the Oct. 24 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1386610#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1386610 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1386596 )

Return to Work Difficult for Doctors on Sick Leave

THURSDAY, Oct. 18 (HealthDay News) -- Returning to work after a prolonged sick leave for physical or mental health problems, or drug or alcohol problems, is difficult for doctors, who describe self-stigmatization and fear a negative response on their return to work, according to a study published online Oct. 15 in BMJ Open.

Abstract (http://bmjopen.bmj.com/content/2/5/e001776.abstract )Full Text (subscription or payment may be required) (http://bmjopen.bmj.com/content/2/5/e001776.full )

No Increase in ICU Death With HES for Fluid Resuscitation

WEDNESDAY, Oct. 17 (HealthDay News) -- Use of hydroxyethyl starch (HES) for fluid resuscitation in the intensive care unit (ICU) is not associated with increased 90-day mortality but does correlate with increased use of renal-replacement therapy, according to a study published online Oct. 17 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the European Society of Intensive Care Medicine, held from Oct. 13 to 17 in Lisbon, Portugal.

Abstract (http://www.nejm.org/doi/full/10.1056/NEJMoa1209759 )Full Text (http://www.nejm.org/doi/full/10.1056/NEJMoa1209759#t=article )More Information (http://www.esicm.org/events/annual-congress )

Chloride-Restriction Lowers Rates of Kidney Injury in ICU

TUESDAY, Oct. 16 (HealthDay News) -- A chloride-restrictive intravenous fluid strategy in the intensive care unit (ICU) is associated with significantly decreased incidence of acute kidney injury (AKI) and use of renal replacement therapy (RRT), according to a pilot study published in the Oct. 17 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1383234#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1383234 )

Collaborative Infection Control Benefits All Regional Hospitals

THURSDAY, Oct. 11 (HealthDay News) -- Collaborative infection control efforts to reduce the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and other organisms are likely to obtain better results than hospitals acting alone, according to research published in the October issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/31/10/2295.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/31/10/2295.full )

CMS Nonpayment Policy Has Not Reduced Infections

WEDNESDAY, Oct. 10 (HealthDay News) -- Implementation of the Centers for Medicare and Medicaid Services (CMS) policy to reduce payment for preventable hospital-acquired conditions in October 2008 has not impacted infection rates in U.S. hospitals, according to a study published in the Oct. 11 issue of the New England Journal of Medicine.

Abstract (http://www.nejm.org/doi/full/10.1056/NEJMsa1202419?query=featured_home )Full Text (http://www.nejm.org/doi/full/10.1056/NEJMsa1202419?query=featured_home#t=article )

Unsuspected PE Seldom Linked to Death in Cancer Patients

TUESDAY, Oct. 9 (HealthDay News) -- Unsuspected pulmonary embolism (UPE) is not associated with an increased risk of death in cancer patients when compared to patients without pulmonary embolism (PE), according to research published in the October issue of the Journal of Thrombosis and Haemostasis.

Abstract (http://onlinelibrary.wiley.com/doi/10.1111/j.1538-7836.2012.04868.x/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1111/j.1538-7836.2012.04868.x/full )

Neonatal Outcomes Unaffected by Transfused Blood Cell Age

MONDAY, Oct. 8 (HealthDay News) -- Premature, very-low-birth-weight infants requiring a blood transfusion do equally well if they receive fresh red blood cells (RBCs) or standard blood bank RBCs, according to a study published online Oct. 8 in the Journal of the American Medical Association to coincide with presentation at the annual meeting of AABB (formerly the American Association of Blood Banks), held from Oct. 6 to 9 in Boston.

Abstract (http://jama.jamanetwork.com/journal.aspx )Full Text (http://jama.jamanetwork.com/article.aspx?articleid=1377715#Abstract )More Information (http://www.aabb.org/events/annualmeeting/Pages/default.aspx )

New Drug Reduces Strokes After Aneurysm Surgery

MONDAY, Oct. 8 (HealthDay News) -- An investigational drug that disrupts neurotoxic signaling pathways is safe and effective in reducing strokes in patients undergoing surgery for a brain aneurysm, according to a study published online Oct. 8 in The Lancet Neurology.

Abstract (http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2812%2970225-9/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2812%2970225-9/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2812%2970229-6/fulltext )

Wide Variation in Screening for Multidrug Organisms in ICUs

FRIDAY, Oct. 5 (HealthDay News) -- The adoption of multidrug resistant organism (MDRO) screening and infection control interventions in intensive care units (ICUs) varies widely, according to a study published in the October issue of the American Journal of Infection Control.

Abstract (http://www.ajicjournal.org/article/S0196-6553(12)00768-7/abstract )Full Text (http://www.ajicjournal.org/article/S0196-6553(12)00768-7/fulltext )

Risk Factors for Tracheostomy in Spinal Cord Injury Identified

THURSDAY, Oct. 4 (HealthDay News) -- Patient age, severe neurological impairment, and forced vital capacity (FVC) are useful for predicting the need for tracheostomy in the management of patients with cervical spinal cord injury (CSCI) in the acute care setting, according to research published online Sept. 19 in Spine.

Abstract (http://journals.lww.com/spinejournal/Abstract/publishahead/Analysis_of_the_Risk_Factors_for_Tracheostomy_in.98079.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/pages/login.aspx?ContextUrl=%2fspinejournal%2fsecure%2fpages%2fpurchase.aspx%3fan%3d00007632-900000000-98079 )

Limiting the Problem of Missing Data Urged for Clinical Trials

WEDNESDAY, Oct. 3 (HealthDay News) -- Missing data compromise inferences from clinical trials, and due to the problematic nature of compensation with analysis methods, the importance of avoiding missing data in clinical trials is paramount, according to a special report published in the Oct. 4 issue of the New England Journal of Medicine.

Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMsr1203730 )

Severe Anemia Linked to Poorer Heart Surgery Outcomes

WEDNESDAY, Oct. 3 (HealthDay News) -- Adults undergoing cardiac surgery who have moderate-to-severe preoperative anemia have significantly increased morbidity and mortality compared with non-severely anemic patients, according to research published in the October issue of the Annals of Thoracic Surgery.

Abstract (http://ats.ctsnetjournals.org/cgi/content/abstract/94/4/1134 )Full Text (subscription or payment may be required) (http://ats.ctsnetjournals.org/cgi/content/full/94/4/1134 )Editorial (subscription or payment may be required) (http://ats.ctsnetjournals.org/cgi/content/extract/94/4/1142 )

Study Finds β-Blockers May Not Reduce Cardiovascular Event Risk

TUESDAY, Oct. 2 (HealthDay News) -- For patients with coronary artery disease (CAD) risk factors alone, previous myocardial infarction (MI), or CAD without MI, β-blockers are not associated with a lower rate of cardiovascular events, according to a study published in the Oct. 3 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1367524#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1367524 )

Increased VTE Risk Seen in Rheumatoid Arthritis Qualified

TUESDAY, Oct. 2 (HealthDay News) -- Rheumatoid arthritis (RA) is associated with an increase in the risk of venous thromboembolism (VTE), a risk that appears stable over the first 10 years after diagnosis, according to a study published in the Oct. 3 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1367509#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1367509 )