January 2019
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Jan 17 2019
AAP – No More Hypotonic MIVF
The AAP now recommends isotonic fluid (+/- KCl and dextrose) in children >28 days to <18 years who need maintenance IV fluid, as opposed to hypotonic solutions.
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Jan 16 2019
Hyperchloremia Kills Kids
Hyperchloremia (an increase ≥5meq/L) in the first day of PICU admission was independently associated with 2.3 times greater odds of in-hospital death in critically ill children.
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Jan 15 2019
Hyper-K Treatment REVEAL-ED
Medical therapy for hyperkalemia is highly variable and will drop the level by about 1mmol/L in 4 hours. Dialysis dropped it about 2.2mmol/L in 4 hours.
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Jan 14 2019
Review – Endovascular Stroke Treatment
Endovascular therapy (EVT) for acute ischemic stroke can dramatically improve outcome. This review helps us makes sense of the trials on this topic.
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Jan 11 2019
Orthostatics – Helpful or Useless?
There’s much debate over the utility of orthostatic vital sign measurement (OVS) to detect orthostatic hypotension (OH) as a cause of syncope.
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Jan 10 2019
Top 10 Signs Your Cancer Patient May Become Critically Ill
This top 10 list may be life saving by helping us identify which cancer patients have a greater chance of becoming critically ill.
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Jan 09 2019
REACTION-US – Ultra-Rapid MI Rule-Out
In this single center, the Generation 5 high-sensitivity troponin T assay would have allowed acute MI rule out at baseline in 29% of patients and 41% at 30 minutes with 100% NPV and sensitivity. This needs multicenter prospective confirmation, but it shows the future feasibility and utility of high sensitivity troponin pathways.
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Jan 08 2019
Near Syncope = Syncope in Elderly
Near syncope had the same risk of death or serious adverse clinical event as syncope in patients ≥60 years old.
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Jan 07 2019
PECARN Abdominal Trauma Rule Performs Well
The PECARN rule for blunt abdominal trauma in children had high sensitivity, 99%, in this retrospective review. A prospective validation study would give us greater confidence to use this in clinical practice.
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Jan 04 2019
PReVENT RCT – Low or Intermediate Tidal Volume in Non-ARDS
In patients with acute respiratory distress, but not ARDS, a low tidal volume (VT) vs intermediate VT strategy did not reduce ventilator-free days or other outcomes, such as 28 or 90-day mortality.