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October 2016 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for October 2016. 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.

Timely Antibiotic Administration Cuts Death in Cirrhosis, UGIB

MONDAY, Oct. 31, 2016 (HealthDay News) -- Timely administration of antibiotics is associated with a reduction in mortality among patients with cirrhosis and upper gastrointestinal bleeding (UGIB), according to a study published in the November issue of Clinical Gastroenterology and Hepatology.

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Few Changes in Employer-Sponsored Insurance 2013-2014

MONDAY, Oct. 31, 2016 (HealthDay News) -- Private sector employer-sponsored health insurance offerings were similar in 2013 and 2014, with <3.5 percent of employers dropping coverage and 1.1 percent adding coverage, according to a report published online Oct. 26 in Health Affairs.

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Heart Failure Care Up, Regardless of Hospital Teaching Status

WEDNESDAY, Oct. 26, 2016 (HealthDay News) -- Adherence to performance measures is similar at teaching hospitals (TH) and nonteaching hospitals (NTH), according to a study published online Oct. 25 in Circulation: Cardiovascular Quality and Outcomes.

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Recommendations for Ventilator Liberation in Hospitalized Adults

WEDNESDAY, Oct. 26, 2016 (HealthDay News) -- In a Clinical Practice Guideline published online Oct. 20 in the American Journal of Respiratory and Critical Care Medicine, recommendations are presented for ventilator liberation for acutely hospitalized adults who have been mechanically ventilated for more than 24 hours.

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Survival Outcomes Similar for Short-, Long-Term Blood Storage

TUESDAY, Oct. 25, 2016 (HealthDay News) -- Using the freshest blood for transfusions does not appear to significantly improve patient survival, according to a study published online Oct. 24 in the New England Journal of Medicine.

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Narrow-Spectrum Abx Feasible in Healthcare-Associated Pneumonia

TUESDAY, Oct. 25, 2016 (HealthDay News) -- It may be safe to switch from broad- to narrow-spectrum antibiotic coverage once hospitalized patients with healthcare-associated pneumonia reach clinical stability, according to a study published online Oct. 3 in the Annals of the American Thoracic Society.

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ICU Clinicians Cautiously Support Electronic Portals

MONDAY, Oct. 24, 2016 (HealthDay News) -- Clinicians are cautiously supportive of an electronic portal to enhance communication in the intensive care unit (ICU), according to a study published online Oct. 4 in the Annals of the American Thoracic Society.

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Mortality Not Up at Nurse-Practitioner-Staffed ICU

MONDAY, Oct. 17, 2016 (HealthDay News) -- Admission to a nurse-practitioner-staffed medical intensive care unit (ICU) is not associated with increased mortality compared with admission to a resident-staffed medical ICU, according to a study published online Sept. 14 in Critical Care Medicine.

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New Recs for RBC Transfusion, Optimal RBC Storage Length

MONDAY, Oct. 17, 2016 (HealthDay News) -- In a clinical practice guideline published online Oct. 12 in the Journal of the American Medical Association, recommendations are presented for the target hemoglobin level for red blood cell (RBC) transfusion and optimal duration of RBC storage.

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CDI Risk Up When Prior Occupant of Hospital Bed Got Antibiotics

TUESDAY, Oct. 11, 2016 (HealthDay News) -- When a hospital patient is taking antibiotics, the next patient to use the same bed may face an elevated risk of Clostridium difficile infection (CDI), according to a study published online Oct. 10 in JAMA Internal Medicine.

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Even Partial Antenatal Steroid Treatment Benefits Preemies

MONDAY, Oct. 10, 2016 (HealthDay News) -- Even partial steroid treatment before birth can improve survival odds for extremely premature infants and reduce their risk of certain birth defects, according to a study published online Oct. 10 in JAMA Pediatrics.

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Ventilators May Be Overused Among Dementia Patients in ICUs

MONDAY, Oct. 10, 2016 (HealthDay News) -- There has been an increase in the use of mechanical ventilation over time without substantial improvement in survival among hospitalized nursing home residents with advanced dementia, according to a study published online Oct. 10 in JAMA Internal Medicine.

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U.S. Health Care System Is One of the Least Efficient Worldwide

MONDAY, Oct. 10, 2016 (HealthDay News) -- The U.S. health care system is one of the least efficient worldwide based on a Bloomberg index that assesses life expectancy, health care spending per capita, and relative spending as a share of gross domestic product, according to a report published by Bloomberg.

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Communication Facilitator Beneficial in Intensive Care Unit

MONDAY, Oct. 10, 2016 (HealthDay News) -- Adding a full-time trained communication facilitator in the intensive care unit (ICU) may improve quality of care while also reducing costs, according to a study published online Sept. 27 in the Annals of the American Thoracic Society.

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Strategies Presented for Managing Physician Burnout

FRIDAY, Oct. 7, 2016 (HealthDay News) -- Effective strategies for managing physician burnout include mindfulness and stress-management training, according to a review published online Sept. 28 in The Lancet.

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Global Burden of Disease Report Evaluates the World's Health

FRIDAY, Oct. 7, 2016 (HealthDay News) -- The United States lags behind other advanced nations when it comes to infant mortality and the life expectancy of its citizens, according to a comprehensive review of global health statistics published in the Oct. 8 issue of The Lancet.

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Hospital Choice Key in Post-Myocardial Infarction Survival

FRIDAY, Oct. 7, 2016 (HealthDay News) -- Older patients with myocardial infarction (MI) who receive immediate high-quality care from their hospital often receive a long-term survival advantage, according to a study published in the Oct. 6 issue of the New England Journal of Medicine.

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Variation in Medicare Payments for Peri-Op Complications

FRIDAY, Oct. 7, 2016 (HealthDay News) -- For patients undergoing four selected inpatient operations, there is considerable variation across hospitals in Medicare payments for those rescued from perioperative complications, according to a study published online Oct. 5 in JAMA Surgery.

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Burns, Blast Injuries on the Rise From Exploding E-Cigarettes

THURSDAY, Oct. 6, 2016 (HealthDay News) -- Electronic-cigarette devices are randomly and unexpectedly exploding, burning and injuring people near them when they detonate, according to a research letter published in the Oct. 6 issue of the New England Journal of Medicine.

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Interruptions in Inpatient Stroke Rehab Often Avoidable

WEDNESDAY, Oct. 5, 2016 (HealthDay News) -- Many interruptions in inpatient rehabilitation for stroke survivors and patients with brain and spinal cord injuries are avoidable, according to a study published online Sept. 14 in the American Journal of Physical Medicine & Rehabilitation.

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Hypothermia No Help When Cardiac Arrest Occurs in Hospital

WEDNESDAY, Oct. 5, 2016 (HealthDay News) -- While therapeutic hypothermia may help improve some outcomes, it doesn't appear to provide benefit when cardiac arrest happens in a hospital setting, according to a study published in the Oct. 4 issue of the Journal of the American Medical Association.

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Doctors Spending in Excess of $32,000 on Health IT

TUESDAY, Oct. 4, 2016 (HealthDay News) -- Doctors are spending more than $32,000 per year on health information technology (IT), according to an article published in Medical Economics.

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New AMA Module Helps Identify Physician Distress

MONDAY, Oct. 3, 2016 (HealthDay News) -- A new resource has been developed to help physicians identify distressed colleagues and help them to access care, according to a report published by the American Medical Association (AMA).

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Physician's Briefing
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