Home Critical Care August 2016 Briefing – Critical Care

August 2016 Briefing – Critical Care

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

Older MI Survivors Have High Event Risk Over Long Term

TUESDAY, Aug. 30, 2016 (HealthDay News) — Older myocardial infarction (MI) survivors have long-term elevated risks of mortality and cardiovascular events, according to a study published online Aug. 26 in Cardiovascular Therapeutics.

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Delirium-Related Training Inadequate for ICU Staff

MONDAY, Aug. 29, 2016 (HealthDay News) — Training related to delirium is inadequate for intensive care unit (ICU) health care professionals, according to a study published online Aug. 18 in the Journal of Clinical Nursing.

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No Impact of Medicaid Expansion on Hospital LOS, Mortality

FRIDAY, Aug. 26, 2016 (HealthDay News) — State Medicaid expansion as part of the Affordable Care Act (ACA) is not associated with length of stay (LOS) or in-hospital mortality among general medicine patients, according to a study published online Aug. 18 in the Journal of Hospital Medicine.

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Survival Benefit for Bronchoscopic Lung Volume Reduction

FRIDAY, Aug. 26, 2016 (HealthDay News) — For patients with heterogeneous emphysema, bronchoscopic lung volume reduction with endobronchial valves (BLVR) is associated with similar survival benefit as lung volume reduction surgery (LVRS), according to a research letter published in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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CDC: Synthetic Fentanyl a Major Factor in Opioid Overdose Deaths

FRIDAY, Aug. 26, 2016 (HealthDay News) — Deaths from overdoses of illicitly manufactured fentanyl have increased significantly in recent years, according to research published in the Aug. 26 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

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Most Clinicians Report That Sleep Quality in ICU Is Poor

FRIDAY, Aug. 26, 2016 (HealthDay News) — Most clinicians believe that sleep in the intensive care unit (ICU) is poor and that poor sleep adversely affects patient outcomes, according to a study published in the August issue of the Annals of the American Thoracic Society.

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In-Hospital Mortality Up With Weekend Admission in NSTEMI

FRIDAY, Aug. 26, 2016 (HealthDay News) — For patients with non-ST-segment elevation myocardial infarction (NSTEMI), weekend admission is associated with increased in-hospital mortality, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Posttraumatic Growth for Parents Post-NICU ‘Under-Evaluated’

THURSDAY, Aug. 25, 2016 (HealthDay News) — For parents of infants previously hospitalized in the neonatal intensive care unit (NICU), posttraumatic growth (PTG) is related to factors such as posttraumatic stress symptoms, positive reinterpretation and growth, and infant survival, according to a study published online Aug. 18 in the Journal of Clinical Nursing.

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CDC Urges Prevention, Early Recognition of Sepsis

WEDNESDAY, Aug. 24, 2016 (HealthDay News) — Many cases of life-threatening sepsis could be recognized and treated long before they cause severe illness or death, according to an Aug. 23 Vital Signs report from the U.S. Centers for Disease Control and Prevention.

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Review: Frailty Status May Predict Outcome After Cardiac Surgery

WEDNESDAY, Aug. 24, 2016 (HealthDay News) — Frailty status may be able to predict outcome in older adults undergoing cardiac surgical procedures, although the quality of evidence is variable, according to a review published online Aug. 23 in the Annals of Internal Medicine.

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A-Fib Tied to Adverse Outcomes in Patients Undergoing PCI

WEDNESDAY, Aug. 24, 2016 (HealthDay News) — For patients undergoing percutaneous coronary intervention (PCI), atrial fibrillation (AF) is associated with in-hospital adverse outcomes, according to a study published in the Aug. 30 issue of the Journal of the American College of Cardiology.

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Postnatal Steroids Tied to Higher Ocular Risk for Premature Infants

MONDAY, Aug. 22, 2016 (HealthDay News) — Postnatal corticosteroid use may increase premature infants’ risk of retinopathy of prematurity (ROP), according to research published recently in the Journal of the American Association for Pediatric Ophthalmology and Strabismus.

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Cardiac Arrest In-Hospital Death Down in Teaching Hospitals

FRIDAY, Aug. 19, 2016 (HealthDay News) — Among patients with cardiac arrest (CA), teaching hospital status is associated with decreased in-hospital mortality, according to a study published in the Sept. 1 issue of The American Journal of Cardiology.

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Antimicrobial Tx Duration Often Exceeds Recommendations

FRIDAY, Aug. 19, 2016 (HealthDay News) — Antimicrobials are often prescribed for a longer duration than recommended in guidelines, according to a study published online Aug. 16 in the Journal of Hospital Medicine.

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Anemia Tied to Increased Mortality Risk Following Stroke

THURSDAY, Aug. 18, 2016 (HealthDay News) — Anemia may increase mortality risk for older stroke patients, according to research published online Aug. 17 in the Journal of the American Heart Association.

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Depression Often Seen in Patients Discharged From ICU

THURSDAY, Aug. 18, 2016 (HealthDay News) — A significant number of former intensive care unit (ICU) patients experience depression, according to a review published in the September issue of Critical Care Medicine.

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Legal Issues Impact Delivery of Telehealth

THURSDAY, Aug. 18, 2016 (HealthDay News) — Telehealth technologies can allow delivery of high-quality care at a lower cost, especially in underserved areas, but there is currently no uniform legal approach to telehealth, hampering its provision, according to a Health Policy Brief published online Aug. 15 in Health Affairs.

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Residents Often Order Perceived Unnecessary Lab Tests

WEDNESDAY, Aug. 17, 2016 (HealthDay News) — Residents frequently order perceived unnecessary inpatient laboratory tests, according to a study published online Aug. 13 in the Journal of Hospital Medicine.

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Antenatal Steroids Don’t Cut Morbidity in Preterm Twins

WEDNESDAY, Aug. 17, 2016 (HealthDay News) — Antenatal administration of corticosteroids is not associated with a reduction in the incidence of respiratory distress syndrome (RDS) in preterm twins, according to research published in the September issue of Obstetrics & Gynecology.

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U.S. Female Doctors Reimbursed Significantly Less Than Males

TUESDAY, Aug. 16, 2016 (HealthDay News) — Female doctors in the United States make much less than their male colleagues, according to a study published online Aug. 15 in the Postgraduate Medical Journal.

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Thrombocytopenia Up With Use of Phosphate-Buffered Tirofiban

TUESDAY, Aug. 16, 2016 (HealthDay News) — For patients with acute coronary syndrome, phosphate-buffered tirofiban, but not citrate-buffered tirofiban, is associated with an increased risk of thrombocytopenia, according to a study published in the Aug. 22 issue of JACC: Cardiovascular Interventions.

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Unstable Vital Signs for About One in Five Hospital Discharges

MONDAY, Aug. 15, 2016 (HealthDay News) — Among adults with a hospitalization, vital sign instability on discharge is associated with increased risk of 30-day mortality and readmission, according to a study published online Aug. 8 in the Journal of General Internal Medicine.

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RSV Found in Aerosol Particles Surrounding Infants With RSV

FRIDAY, Aug. 12, 2016 (HealthDay News) — Infants with respiratory syncytial virus (RSV)-positive bronchiolitis produce large numbers of aerosol particles containing RSV that remain infectious for a significant length of time, according to a study published in the Aug. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Hand Hygiene Program Improves Hygiene Compliance

FRIDAY, Aug. 12, 2016 (HealthDay News) — Implementation of a hand hygiene program can improve compliance with hand hygiene and reduce health-care-associated infections (HAIs), according to a study published online Aug. 10 in Emerging Infectious Diseases.

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Considerable Health Care System Burden for Undiagnosed COPD

FRIDAY, Aug. 12, 2016 (HealthDay News) — The overall health system burden of exacerbations in patients with undiagnosed chronic obstructive pulmonary disease (COPD) is considerable, according to a study published in the Aug. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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About Half of Older ICU Survivors Have Functional Recovery

THURSDAY, Aug. 11, 2016 (HealthDay News) — About half of older intensive care unit (ICU) survivors have functional recovery within six months, with higher body mass index and functional self-efficacy associated with recovery, according to a study published in the Aug. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Suicide Rate Increased in Patients With Serious Infections

WEDNESDAY, Aug. 10, 2016 (HealthDay News) — Patients hospitalized for serious infections may face an increased risk of suicide, according to research published online Aug. 10 in JAMA Psychiatry.

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Risk of Post-Op Opioid Abuse Deemed Low for Elderly Patients

WEDNESDAY, Aug. 10, 2016 (HealthDay News) — Opioid abuse arises in only a very small fraction — less than half of 1 percent — of cases involving surgical patients aged 65 or older, according to a research letter published online Aug. 10 in JAMA Surgery.

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Many U.S. Hospitals Offer Language Services

WEDNESDAY, Aug. 10, 2016 (HealthDay News) — Overall, 68.8 percent of hospitals offer language services, with the proportion increasing with level of need, according to research published in the August issue of Health Affairs.

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Counterfeit Alprazolam Cut With Fentanyl Can Be Fatal

WEDNESDAY, Aug. 10, 2016 (HealthDay News) — At least one San Francisco-area individual died and eight more were treated in the emergency department in late 2015 after taking counterfeit alprazolam (Xanax) tablets that had been cut with fentanyl, according to a case report published online Aug. 8 in JAMA Internal Medicine.

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ICU May Up Invasive Procedures, Costs, Without Mortality Benefit

MONDAY, Aug. 8, 2016 (HealthDay News) — Hospitals with higher intensive care unit (ICU) utilization for four common conditions have greater use of invasive procedures and costs of hospitalization, but do not have improved hospital mortality, according to a study published online Aug. 8 in JAMA Internal Medicine.

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Sickle Cell Trait Doesn’t Up Mortality Risk in U.S. Soldiers

WEDNESDAY, Aug. 3, 2016 (HealthDay News) — Sickle cell trait is not associated with a higher risk of death than absence of the trait, but it is associated with a significantly increased risk of exertional rhabdomyolysis, according to a study published in the Aug. 4 issue of the New England Journal of Medicine.

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Vasopressin Doesn’t Cut Kidney Failure-Free Days in Septic Shock

WEDNESDAY, Aug. 3, 2016 (HealthDay News) — Among adults with septic shock, early use of vasopressin does not improve the number of kidney failure-free days versus norepinephrine, according to a study published in the Aug. 2 issue of the Journal of the American Medical Association.

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Memories of Delusions in ICU Include Fact, Fiction

TUESDAY, Aug. 2, 2016 (HealthDay News) — Memories of delusions in the intensive care unit are composed of a mixture of fact and fiction, and are not dependent on the presence of delirium, according to a study published online July 26 in the Journal of Clinical Nursing.

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European Countries Implementing Cost-Sharing

MONDAY, Aug. 1, 2016 (HealthDay News) — European health systems are requiring an increase in cost-sharing measures for patients 50 years of age and older, according to research published in the July issue of Health Affairs.

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Hospitalizations for Heart Failure With Preserved EF Common

MONDAY, Aug. 1, 2016 (HealthDay News) — Heart failure with preserved ejection fraction (HFpEF) is common among patients hospitalized with acute heart failure, and patients with HFpEF are older, more often female, and frequently have comorbidities, according to a study published in the June issue of The American Journal of Medicine.

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