September 2021
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Sep 16 2021
How Fast Should I be Giving Fluids to My Sick Patient? – The BaSICS RCT Part 1
Spoon Feed There was no difference in 90-day mortality in critically ill ICU patients randomized to receive IV fluid at a slow versus rapid infusion rate.Read More -
Sep 15 2021
DKA Fluid Choice, Dropping Sodium, and AMS – Is There Correlation?
Spoon Feed In pediatric patients with DKA, a decline in serum sodium was associated with a higher starting sodium level, preexisting diabetes, and use of 0.45% saline. Patients with a drop in sodium during treatment did not have an associated increase in altered mental status.Read More -
Sep 14 2021
Fluid Balance in TBI – Don’t Drown the Brain
Spoon Feed In patients with TBI, aim for normovolemia. Positive fluid balance was associated with increased mortality and poorer neurological outcome.Read More -
Sep 13 2021
Balanced Fluids in Critically Ill Children
Spoon Feed There was no difference in acute kidney injury on day 3 or other longer-term outcomes after a single PICU switched from normal saline to balanced fluid.Read More -
Sep 10 2021
DOREMI RCT – Milrinone vs Dobutamine for Cardiogenic Shock
Spoon Feed In patients requiring inotropic support for treatment of cardiogenic shock, there was no difference between milrinone and dobutamine with respect to the primary composite outcome.Read More -
Sep 09 2021
Impact of POCUS on Ectopic Pregnancy
Spoon Feed Using point of care ultrasound (POCUS) to assess for ectopic pregnancy is associated with shorter ED length of stay for all ectopic pregnancies and faster time to the OR for ruptured ectopics, when compared to radiology-based US alone.Read More -
Sep 08 2021
Stop Waiting on That CXR for Heart Failure
Spoon Feed In older adults (> 50 years old) presenting with shortness of breath, point-of-care lung ultrasound was more sensitive in making the diagnosis of acute heart failure as compared to a radiologist-read CXR.Read More -
Sep 07 2021
Do COVID Vaccines Prevent Hospitalizations?
Spoon Feed The short answer is YES. Full vaccination against the SARS-CoV-2 virus was highly effective at preventing COVID-19 hospitalizations (87.1% effective). Vaccine efficacy was lower for immunocompromised patients (62.9% effective), and breakthrough infections were more common in patients who were older and immunocompromised.Read More -
Sep 06 2021
Can We Discharge Intermediate Risk HEART Score Patients?
Spoon Feed Risk of in-hospital clinically relevant adverse cardiac events (CRACE) among patients with a HEART score of 4-6 (with non-diagnostic ECG and negative troponin) was 0.5%. I am not planning to start discharging intermediate risk patients.Read More -
Sep 03 2021
Landmark Febrile Neonate, Febrile Infant Guideline from the AAP
Spoon Feed This covers the epic, 40-page AAP febrile neonate and febrile infant guideline. This is a game-changing, must-read summary and article.Read More