Monthly Briefings

January 2012 Briefing - Critical Care

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

Sixty Percent Burn Size Crucial Threshold in Children

TUESDAY, Jan. 31 (HealthDay News) -- Children with burns covering 60 percent of their body or more are at much higher risk for complications and death and should receive specialized care, according to a study published online Jan. 31 in The Lancet.

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More Research Needed on Weaning of Addicted Infants

MONDAY, Jan. 30 (HealthDay News) -- More research is necessary to identify the optimal treatment strategy for weaning infants with neonatal drug withdrawal, but updates for clinical identification and monitoring of opioid-exposed infants have been presented in a guidance statement from the American Academy of Pediatrics (AAP) published online Jan. 30 in Pediatrics.

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Steroid-Sparing Renal Transplant Yields Successful Outcomes

FRIDAY, Jan. 27 (HealthDay News) -- Rapid discontinuation of prednisone (RDP) five days after renal transplantation from a living (LD) or deceased donor (DD) yields acceptable 10-year patient and graft outcomes, according to research published online Jan. 26 in the Clinical Journal of the American Society of Nephrology.

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COPD Assessment Test Predicts Exacerbation Severity

FRIDAY, Jan. 27 (HealthDay News) -- The COPD Assessment Test (CAT) provides a reliable score of exacerbation severity in patients with chronic obstructive pulmonary disease (COPD), according to a study published online Jan. 26 in the American Journal of Respiratory and Critical Care Medicine.

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No Complications From Using Stored Red Blood Cells

FRIDAY, Jan. 27 (HealthDay News) -- There is no significant difference in early complications, including measures of pulmonary function, immunologic status, or coagulation status, after using fresh versus standard issue red blood cell (RBC) transfusions, according to a study published online Jan. 26 in the American Journal of Respiratory and Critical Care Medicine.

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ACE Inhibitors Not Linked to Improved Outcomes After ACS

THURSDAY, Jan. 26 (HealthDay News) -- For patients with acute coronary syndrome (ACS), prior chronic use of an angiotensin-converting enzyme (ACE) inhibitor is not independently associated with improved in-hospital outcomes, according to a study published in the Feb. 1 issue of The American Journal of Cardiology.

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Anaphylactic Shock After Immunizations Is Rare

THURSDAY, Jan. 26 (HealthDay News) -- Anaphylactic shock following immunization is extremely rare in children, and in the few reported cases, some children have a delayed onset of symptoms, according to a study published online Jan. 23 in the Archives of Disease in Childhood.

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Overuse of Health Care Services Understudied

WEDNESDAY, Jan. 25 (HealthDay News) -- Overuse of health care services in the United States is an understudied problem, with the majority of research limited to a few interventions, according to a review published in the Jan. 23 issue of the Archives of Internal Medicine.

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Unemployed Have Poorer Mental and Physical Health

TUESDAY, Jan. 24 (HealthDay News) -- Unemployed adults are about half as likely to have health insurance as employed individuals; have poorer mental and physical health, regardless of their insurance status; and are less likely to receive needed medical care and prescriptions, according to a January data brief issued by the National Center for Health Statistics.

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HealthGrades IDs Notable Hospitals for Clinical Excellence

TUESDAY, Jan. 24 (HealthDay News) -- The top 5 percent of U.S. hospitals has more than a 30 percent lower risk-adjusted mortality across 17 procedures and diagnoses, compared with other hospitals, according to the 10th annual HealthGrades Hospital Quality and Clinical Excellence study published online Jan. 24.

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Fetal Growth Not Linked to Childhood Asthma

TUESDAY, Jan. 24 (HealthDay News) -- Fetal growth restriction or acceleration is not associated with asthma symptoms in childhood, according to a study published online Jan. 20 in the American Journal of Respiratory and Critical Care Medicine.

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Effects of Severe, Childhood Brain Injury Long Lasting

MONDAY, Jan. 23 (HealthDay News) -- There is a high risk of persisting deficits following severe, childhood traumatic brain injury (TBI), according to a study published online Jan. 23 in Pediatrics.

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Dosing Errors Occur With IV Acetaminophen in Children

MONDAY, Jan. 23 (HealthDay News) -- Use of a new intravenous formulation of acetaminophen is associated with dosing errors in neonates, infants, and small children, and evaluation and management of these dosing errors are similar to oral overdose, according to a report published online Jan. 23 in Pediatrics.

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Warfarin Patients With Head Trauma Need Second CT Scan

FRIDAY, Jan. 20 (HealthDay News) -- For patients on warfarin with minor head trauma who have an initial negative computed tomography (CT) scan, 24-hour observation followed by an additional CT scan identifies the majority of cases of delayed bleeding, according to a study published online Jan. 16 in the Annals of Emergency Medicine.

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Worse Outcomes for Stroke Patients With Delirium

THURSDAY, Jan. 19 (HealthDay News) -- Stroke patients who develop delirium have worse outcomes, including higher mortality and longer hospitalizations, and are more likely to be discharged to a care facility, according to a review published online Jan. 19 in Stroke.

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Sexual Activity Safe for Most Cardiovascular Disease Patients

THURSDAY, Jan. 19 (HealthDay News) -- For most individuals with stable cardiovascular disease (CVD), sexual activity is safe, according to a scientific statement from the American Heart Association published online Jan. 19 in Circulation.

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No Long-Term Benefit of Caffeine for Apnea in Preemies

TUESDAY, Jan. 17 (HealthDay News) -- Neonatal caffeine therapy for apnea of prematurity is no longer associated with increased survival without disability when assessed at five-year follow-up, according to a study published in the Jan. 18 issue of the Journal of the American Medical Association.

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Endovascular Graft Approved for Tears of Aorta

MONDAY, Jan. 16 (HealthDay News) -- The U.S. Food and Drug Administration has expanded approval of an endovascular graft to include ruptures of the aorta.

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Fatal Case of Measles Without Rash Found in Young Woman

FRIDAY, Jan. 13 (HealthDay News) -- A fatality from measles with acute respiratory distress syndrome (ARDS), but without rash, has been reported, according to a study published online Jan. 11 in the U.S. Centers for Disease Control and Prevention's Emerging Infectious Diseases.

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U.S. Health Care Expenditure Still Unevenly Distributed

FRIDAY, Jan. 13 (HealthDay News) -- Health care expenditure in the United States is still unevenly distributed, with 1 percent of the population accounting for approximately 20 percent of expenditure in 2008 and 2009, according to a January statistical brief published by the Agency for Healthcare Research and Quality (AHRQ).

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Site of Blood Collection From IV Does Not Affect Hemolysis Rate

THURSDAY, Jan. 12 (HealthDay News) -- No statistically significant difference in the rate of hemolysis is observed when emergency department nurses collect coagulation blood samples directly via catheter hub or via extension tubing connected to the intravenous (IV) catheter hub, according to a study published in the January issue of the Journal of Emergency Nursing.

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Subclinical Tachyarrhythmias Tied to Increased Risk of Stroke

WEDNESDAY, Jan. 11 (HealthDay News) -- Subclinical atrial tachyarrhythmias, which occur in approximately 10 percent of patients in the first three months after pacemaker or defibrillator implantation, are associated with an increased risk of clinical atrial fibrillation, stroke, and systemic embolism, according to a study published in the Jan. 12 issue of the New England Journal of Medicine.

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CDC: 2010 Saw Decrease in Age-Adjusted Death Rates

WEDNESDAY, Jan. 11 (HealthDay News) -- From 2009 to 2010, age-adjusted death rates decreased and life expectancy increased, according to a Jan. 11 report published by the U.S. Centers for Disease Control and Prevention.

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Hypertension Registry IDs Features of Pediatric HTN

WEDNESDAY, Jan. 11 (HealthDay News) -- An analysis of data from the Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension (TOPP) registry has identified clinical features specific to the care of children with pulmonary hypertension, according to research published online Jan. 11 in The Lancet.

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Asian-American Heart Attack Care Now Similar to Whites

WEDNESDAY, Jan. 11 (HealthDay News) -- Recently, the quality of care following acute myocardial infarction (AMI) has improved for Asian-American and white patients, and the differences in care between Asian and white patients have also been reduced, according to a study published online Jan. 10 in Circulation: Cardiovascular Quality and Outcomes.

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Rx Provides Fast Relief of Pain, Urgency of Interstitial Cystitis

WEDNESDAY, Jan. 11 (HealthDay News) -- Alkalinized lidocaine plus heparin provides significant and immediate relief from the pain and urgency symptoms of interstitial cystitis (IC) for 12 hours after treatment, according to a study published in the January issue of the Journal of Sexual Medicine.

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Dementia Associated With More Hospital Admissions

TUESDAY, Jan. 10 (HealthDay News) -- Hospital admission rates for all causes, and for ambulatory care-sensitive conditions (ACSCs), are significantly higher among patients with dementia compared to older patients without dementia, according to a study published in the Jan. 11 issue of the Journal of the American Medical Association.

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Too High, Too Low Serum Potassium Linked to Mortality

TUESDAY, Jan. 10 (HealthDay News) -- Patients hospitalized after an acute myocardial infarction (AMI) with post-admission serum potassium levels between 3.5 and 4.5 mEq/L (milliEquivalents per liter) have a lower risk of death than those with higher or lower levels, according to a study published in the Jan. 11 issue of the Journal of the American Medical Association.

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Long-Term Prognostic Value of Dobutamine Stress Echo Limited

TUESDAY, Jan. 10 (HealthDay News) -- Dobutamine stress echocardiography (DSE) has limited long-term predictive value for patients with diabetes who are unable to perform an exercise stress test, particularly during the first seven years after initial testing, according to a study published online Jan. 6 in Diabetes Care.

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Ped Heart Surgery Deaths Higher at Low Volume Centers

MONDAY, Jan. 9 (HealthDay News) -- Postoperative mortality rates from complications after pediatric heart surgery are higher at centers with a lower volume of cases, according to a study published online Jan. 9 in Pediatrics.

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Hypoglycemia in Intensive Diabetes Control May Up Survival

FRIDAY, Jan. 6 (HealthDay News) -- For adults with type 2 diabetes, recognized and unrecognized hypoglycemia is more common in those with intensive blood sugar control, and is associated with a small but significant reduction in the risk of mortality, according to a study published online Dec. 16 in Diabetes Care.

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Glucose-Lowering Algorithm Safe in Coronary Care Unit

FRIDAY, Jan. 6 (HealthDay News) -- In coronary care unit (CCU) patients, a paper-based glucose-lowering algorithm with target serum glucose levels of 5.0 to 6.5 mmol/L (90 to 117 mg/dL) can be safely implemented, but further studies are needed to assess cardiovascular outcomes, according to research published in the January issue of Diabetes Care.

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In-Hospital, 30-Day Standardized Mortality Measures Differ

THURSDAY, Jan. 5 (HealthDay News) -- The mean risk-standardized mortality rates (RSMRs) differ for in-hospital and 30-day models, with wide variability across U.S. hospitals, according to a study published in the Jan. 3 issue of the Annals of Internal Medicine.

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Multiple Blockages, U.S. Heart Attack Care Ups Readmissions

TUESDAY, Jan. 3 (HealthDay News) -- Patients treated for heart attacks in the United States have shorter initial hospital stays but significantly higher rates of 30-day readmission compared with patients in other countries, according to a study published in the Jan. 4 issue of the Journal of the American Medical Association.

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Bariatric Surgery Tied to Reduced CVD Events, Mortality

TUESDAY, Jan. 3 (HealthDay News) -- For obese individuals, bariatric surgery is associated with significantly reduced incidence of cardiovascular events, and decreased cardiovascular death, versus usual care, according to a study published in the Jan. 4 issue of the Journal of the American Medical Association.

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