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April 2012 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for April 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.

Heart Surgery Safe for Compensated Cirrhosis Patients

THURSDAY, April 26 (HealthDay News) -- Patients with compensated cirrhosis, defined by a Child-Pugh (CP) score of <8, have no significant increase in postoperative mortality and morbidity following cardiac surgery with cardiopulmonary bypass, according to a study published in the May issue of Clinical Gastroenterology and Hepatology.

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Warfarin Keeps Stroke Risk Low in Patients With A-Fib

WEDNESDAY, April 25 (HealthDay News) -- Use of warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (AF) is associated with a low risk of stroke or systemic embolism, according to a meta-analysis published in the April 23 issue of the Archives of Internal Medicine.

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Mortality High for Cardiac Device Infective Endocarditis

TUESDAY, April 24 (HealthDay News) -- Patients with infective endocarditis involving implanted cardiac devices experience high in-hospital and one-year mortality rates, particularly if there is valve involvement, according to a study published in the April 25 issue of the Journal of the American Medical Association.

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Angiotensin Receptor Blockers Reduce No-Reflow Post-PCI

MONDAY, April 23 (HealthDay News) -- For patients with acute myocardial infarction (AMI), pretreatment with angiotensin receptor blockers (ARBs) is linked with reduced incidence of the no-reflow phenomenon after percutaneous coronary intervention (PCI), according to a study published online April 10 in Cardiovascular Therapeutics.

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Reliability, Validity of Clinical Dehydration Scale Questioned

MONDAY, April 23 (HealthDay News) -- A previously derived clinical dehydration scale (CDS) is characterized by moderate interobserver reliability and weak links with objective measures of disease severity for children administered intravenous rehydration, according to a study published online April 23 in Pediatrics.

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QRS Width on ECG Linked to Sudden Cardiac Arrest in CAD

FRIDAY, April 20 (HealthDay News) -- For patients with coronary artery disease (CAD), QRS width on electrocardiogram and echocardiographic evidence of heart failure are associated with out-of-hospital sudden cardiac arrest (SCA), regardless of whether they have a history of previous myocardial infarction (MI), according to a study published in the May 1 issue of The American Journal of Cardiology.

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Pulmonary HTN Predicts Heart Failure After Acute MI

THURSDAY, April 19 (HealthDay News) -- Pulmonary hypertension (PH) is a strong independent predictor of heart failure in patients with acute myocardial infarction (AMI), according to a study published in the May 1 issue of The American Journal of Cardiology.

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Use of PICU Beds for Non-Critical Care Found to Be Significant

THURSDAY, April 19 (HealthDay News) -- Pediatric intensive care unit (PICU) beds are used for critical care services the majority of the time, but even when new patients are waiting for floor beds, at least one PICU bed is usually in use for non-critical care services, according to a study published in the April issue of the Journal of Hospital Medicine.

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For Major Trauma, Survival Up With Helicopter Transport

TUESDAY, April 17 (HealthDay News) -- For patients with major trauma who are admitted to level I or II trauma centers, those who are transported by helicopter have improved survival compared to those transported by ground emergency medical services, according to a study published in the April 18 issue of the Journal of the American Medical Association, a theme issue on comparative effectiveness research.

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Rate Down But Unintentional Injury Still Top Cause of Death

TUESDAY, April 17 (HealthDay News) -- Although the unintentional injury death rate has declined over the last decade, it is still the leading cause of death among children and adolescents in the United States, according to a study published in the April 16 early-release issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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Noninvasive Monitoring of Intracranial Pressure Viable

FRIDAY, April 13 (HealthDay News) -- A model-based, patient-specific, calibration-free approach has been developed for estimation of intracranial pressure (ICP), according to a study published in the April 11 issue of Science Translational Medicine.

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TAVI Beneficial in Severe Aortic Stenosis

FRIDAY, April 13 (HealthDay News) -- While all-cause mortality is high in low-flow, low-gradient aortic stenosis patients receiving transcatheter aortic valve implantation (TAVI), surviving patients show significant improvements, according to a study published in the April issue of Catheterization & Cardiovascular Interventions.

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Mobile Stroke Units Halve Time to Treatment

WEDNESDAY, April 11 (HealthDay News) -- Diagnosis and treatment of stroke in patients at the scene of the emergency rather than at the hospital about halves the time to treatment, according to a study published online April 11 in The Lancet Neurology.

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Increased Risk of Fatal Road Crashes on Tax Day in the U.S.

TUESDAY, April 10 (HealthDay News) -- There is a small, but significant, increase in fatal road crashes on tax day in the United States, according to a letter published in the April 11 issue of the Journal of the American Medical Association.

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Report Highlights Child Deaths From Post-Surgery Codeine Use

MONDAY, April 9 (HealthDay News) -- Researchers have identified three previously unreported instances of severe opioid-induced toxicity in children following adenotonsillectomy for obstructive sleep apnea syndrome, according to a case report published online April 9 in Pediatrics.

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Infection May Be Trigger for Venous Thromboembolism

MONDAY, April 9 (HealthDay News) -- Older adults recovering from an infection are at increased risk of being hospitalized for a venous thromboembolism (VTE), according to a study published online April 3 in Circulation.

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Medical Malpractice Claims Incur Substantial Defense Costs

WEDNESDAY, April 4 (HealthDay News) -- Defense costs for medical malpractice claims vary among specialties and are higher for claims that result in indemnity payments, according to a letter published in the April 5 issue of the New England Journal of Medicine.

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Diagnostic Coding May Skew Pneumonia Outcomes Data

WEDNESDAY, April 4 (HealthDay News) -- The decline in pneumonia-related hospitalizations and associated inpatient deaths seen in 2003 to 2009 may be a result of diagnostic coding, rather than an actual improvement in outcomes, according to a study published in the April 4 issue of the Journal of the American Medical Association.

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Antibiotic-Resistant S. aureus Found in Many Ambulances

WEDNESDAY, April 4 (HealthDay News) -- Antibiotic-resistant strains of Staphylococcus aureus (S. aureus) are found in the majority of advanced life support (ALS) ambulances in the Chicago area, according to a study published in the April issue of the American Journal of Infection Control.

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Inflammatory Regulation Plays Role in Stress, Illness Link

TUESDAY, April 3 (HealthDay News) -- People under chronic stress have glucocorticoid receptor resistance (GCR), which is linked to increased risk of illness, according to research published online April 2 in the Proceedings of the National Academy of Sciences.

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Guidelines Improve Outcomes in Nonshockable Cardiac Arrest

MONDAY, April 2 (HealthDay News) -- Implementation of the latest American Heart Association (AHA) resuscitation guidelines, which eliminate "stacked" shocks and emphasize chest compressions, results in significantly improved outcomes for patients experiencing nonshockable out-of-hospital cardiac arrest (OHCA), according to a study published online April 2 in Circulation.

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Operator Sleep Deprivation Does Not Adversely Affect PCI

MONDAY, April 2 (HealthDay News) -- Percutaneous coronary intervention (PCI) performed in the middle of the night does not impact the same operator's ability to perform PCI the next day, according to a study published online March 30 in Catheterization and Cardiovascular Interventions.

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