July 2011 Briefing - Critical CareLast Updated: August 01, 2011.
Here are what the editors at HealthDay consider to be the most important developments in Critical Care for July 2011. 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.
Low-Molecular-Weight Heparin Better for Primary PCI
FRIDAY, July 29 (HealthDay News) -- Compared to unfractionated heparin (UFH), low-molecular-weight heparin (LMWH) is associated with reduced mortality and reduced major bleeding in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI); but it shows no benefit in those treated with PCI after thrombolysis, according to a study published online July 20 in the Journal of Thrombosis and Haemostasis.
Traumatic Brain Injury Linked to Increased Stroke Risk
FRIDAY, July 29 (HealthDay News) -- Individuals who sustain a traumatic brain injury (TBI) are at an increased risk of stroke, with more than 10 times higher risk in the first three months, according to a study published online July 28 in Stroke.
Pregnancy-Related Stroke Hospitalizations Rise in the U.S.
THURSDAY, July 28 (HealthDay News) -- The rate of pregnancy-related hospitalizations for stroke have increased in the United States, especially during the postpartum period, from 1994-1995 to 2006-2007, mainly due to changes in prevalence of hypertension and heart disease, according to a study published online July 28 in Stroke.
Apixaban Ups Bleeding Without Reducing Ischemic Events
TUESDAY, July 26 (HealthDay News) -- Adding 5 mg of apixaban twice daily to antiplatelet therapy among high-risk patients after an acute coronary syndrome increases the risk of bleeding events without a significant reduction in recurrent ischemic events, according to a study published online July 24 in the New England Journal of Medicine.
Optimism Linked to Reduced Risk of Stroke in Older Adults
TUESDAY, July 26 (HealthDay News) -- Increased optimism is associated with a decreased risk of stroke in older adults, even after adjusting for sociodemographic, behavioral, biological, and psychological stroke risk factors, according to a study published online July 21 in Stroke.
Non-Receipt of Fluids in Children Tied to Increased Oligoanuria
MONDAY, July 25 (HealthDay News) -- Young patients with pre-hemolytic uremic syndrome (HUS) diarrhea, who do not receive intravenous fluids within the first four days of diarrhea onset, have increased risk of developing oligoanuria, according to a study published online July 22 in the Archives of Pediatrics & Adolescent Medicine.
Hemolysis Products Impair Nitric Oxide Function on Infusion
MONDAY, July 25 (HealthDay News) -- The products of hemolysis, which accumulate in blood stored under standard conditions, interact with nitric oxide (NO) on infusion and impair its vascular function, according to an experimental study published online July 11 in Circulation.
Pagibaximab Seems Safe, Well Tolerated in High-Risk Neonates
MONDAY, July 25 (HealthDay News) -- Three once-a-week infusions of 90 mg/kg of pagibaximab in neonates who are at high risk for staphylococcal sepsis appears to be safe and well tolerated, with no cases of staphylococcal sepsis occurring, according to a study published online July 25 in Pediatrics.
Lower In-Hospital Mortality for Obese Patients With RI/ARDS
MONDAY, July 25 (HealthDay News) -- Obesity is associated with a decreased incidence of in-hospital mortality in patients who develop postoperative respiratory insufficiency (RI)/adult respiratory distress syndrome (ARDS), according to a study published online July 21 in the Journal of Intensive Care Medicine.
FDA: Dronedarone Tied to Cardiovascular Events, Death
FRIDAY, July 22 (HealthDay News) -- The U.S. Food and Drug Administration has notified health care professionals and patients that dronedarone (Multaq) may be associated with an increased risk of death and adverse cardiovascular events, including stroke and hospitalization for heart failure.
Being Married Linked to Earlier Care After Chest Pain
FRIDAY, July 22 (HealthDay News) -- Though married status is associated with lower odds of delayed medical care after chest pain, married men are significantly more likely to present earlier for care after myocardial infarction (MI) with chest pain, but married women show no such benefit, according to a study published online July 18 in CMAJ, the journal of the Canadian Medical Association.
Brilinta Approved for Acute Coronary Syndromes
THURSDAY, July 21 (HealthDay News) -- Brilinta (ticagrelor) has been approved by the U.S. Food and Drug Administration to help reduce the risk of heart attack and cardiovascular death among people with acute coronary syndromes (ACS).
Disrupted Thalamic MRI Patterns in Mild Traumatic Brain Injury
THURSDAY, July 21 (HealthDay News) -- In patients with mild traumatic brain injury (MTBI), resting-state magnetic resonance imaging (MRI) patterns are disrupted, with significantly increased thalamic resting-state networks (RSNs) and reduced symmetry, according to a study published online July 20 in Radiology.
Decrease in Rate of Surgical Adverse Events in VHA Centers
THURSDAY, July 21 (HealthDay News) -- The rate of adverse events for surgical procedures and harm in the Veterans Health Administration (VHA) system decreased from 2006 to 2009 while reported close calls increased, according to a study published online July 18 in the Archives of Surgery.
Medical Students Support Right to Conscientious Objection
THURSDAY, July 21 (HealthDay News) -- Nearly half of medical students in the United Kingdom, especially Muslims, believe in the right of doctors to conscientiously object to or refuse any procedure, according to a study published online July 18 in the Journal of Medical Ethics.
FDA Approves Vaccine for 2011/2012 Influenza Season
TUESDAY, July 19 (HealthDay News) -- The U.S. Food and Drug Administration announced that the agency has approved the influenza vaccine formulation for the 2011/2012 influenza season; this formulation will be used by the six manufacturers licensed to manufacture and distribute the vaccine in the United States.
Children Safer in Car Crashes When Grandparents Driving
MONDAY, July 18 (HealthDay News) -- Children have a reduced risk of injury in crashes with grandparents as drivers than with parents, despite less optimal use of child restraint in grandparent-driver crashes, according to a study published online July 18 in Pediatrics.
'Rule of Rescue' Trumps Societal Benefits in ICU
THURSDAY, July 14 (HealthDay News) -- More than one-third of intensive care unit (ICU) clinicians are willing to forego societal benefits to prioritize ICU allocation to a living, critically ill patient over a dead or dying patient who would be a potential organ donor, according to a study published in the July issue of Intensive Care Medicine.
Timely Surgery in Traumatic Brain Injury Halves Death Rate
THURSDAY, July 14 (HealthDay News) -- For patients with traumatic brain injury (TBI), shorter time from emergency department (ED) arrival to surgery significantly lowers mortality and length of hospital stay (LOS), according to a study published in the July issue of the Journal of Emergency Nursing.
Therapeutic Hypothermia Care Improves STEMI Outcomes
TUESDAY, July 12 (HealthDay News) -- A comprehensive therapeutic hypothermia (TH) protocol integrated into regional ST-segment elevation myocardial infarction (STEMI) treatment improves survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA), according to a study published in the July 12 issue of Circulation.
Increase in Staph Pneumonia in Children Mainly Due to MSRA
MONDAY, July 11 (HealthDay News) -- The number of Staphylococcus aureus (SA) pneumonia cases in children increased between August 2001 and April 2009, with methicillin-resistant SA (MRSA) responsible for 74 percent of the cases, according to a study published in the July issue of the Pediatric Infectious Disease Journal.
Combination Therapy for A-Fib Increases Bleeding Risk
FRIDAY, July 8 (HealthDay News) -- Combination antithrombotic therapy for patients with atrial fibrillation (AF) is associated with an increased risk of bleeding and no reduction in the risk of stroke, according to a study published in the July issue of Chest.
Factors in Acinetobacter Infection Transmission ID'd
FRIDAY, July 8 (HealthDay News) -- The identification of themes involved in the transmission of multi-drug resistant (MDR) Acinetobacter infections, sources of transmission, and interventions to reduce infections offer new insight into MDR Acinetobacter infections in war injuries, according to a review published in the July issue of the AORN Journal.
Long-Term Indacaterol Effective in Pulmonary Disease
THURSDAY, July 7 (HealthDay News) -- Patients with chronic obstructive pulmonary disease (COPD) tolerate indacaterol well, and have improved bronchodilation at 52 weeks, according to a study published in the July issue of Chest.
Nesiritide Has Small, Nonsignificant Effect on Dyspnea
WEDNESDAY, July 6 (HealthDay News) -- Use of nesiritide has a small, nonsignificant effect on dyspnea in patients with acute heart failure, and is not associated with changes in rates of death and rehospitalizations, according to a study published in the July 7 issue of the New England Journal of Medicine.
Withdrawal of Life Support Main Mode of NICU Deaths
WEDNESDAY, July 6 (HealthDay News) -- Withdrawing life-sustaining support is the primary mode of death in the neonatal intensive care unit (NICU), and there has been a significant annual increase in withholding of care, according to a study published in the July issue of the Archives of Pediatrics & Adolescent Medicine.
Stroke Burden Shows Substantial Global Variation
WEDNESDAY, July 6 (HealthDay News) -- Stroke burden shows substantial global variation compared to ischemic heart disease (IHD), with countries with lower national income having disproportionately higher stroke death and disease burden than IHD, according to a study published online July 5 in Circulation.
Fewer Clinical Capabilities in Critical Access Rural Hospitals
TUESDAY, July 5 (HealthDay News) -- Rural critical access hospitals (CAHs) have fewer clinical capabilities, significantly poorer performance on process measures, and higher 30-day mortality rates than non-CAHs for patients with acute myocardial infarction (AMI), congestive heart failure, and pneumonia, according to a study published in the July 6 issue of the Journal of the American Medical Association.
Arcapta Inhaler Approved for COPD
TUESDAY, July 5 (HealthDay News) -- The Arcapta Neohaler (indacaterol inhalation powder) has been approved by the U.S. Food and Drug Administration for the long-term treatment of chronic obstructive pulmonary disease (COPD).
Increasing Incidence of U.S. In-Hospital Cardiac Arrests
TUESDAY, July 5 (HealthDay News) -- Approximately 200,000 patients are treated for in-hospital cardiac arrest (IHCA) annually in the United States, according to a study published online June 23 in Critical Care Medicine.
Blood Pressure Variability Tied to Heart Surgery Mortality
FRIDAY, July 1 (HealthDay News) -- Variations in perioperative blood pressure are associated with 30-day mortality in cardiac surgical patients, with increased mortality risks for high-risk than low-risk patients, according to a study published in the July issue of Anesthesia & Analgesia.