In patients who presented with recent onset atrial fibrillation < 36h, delayed cardioversion at 48h compared to early cardioversion was non-inferior (91% vs 94%; -2.9 percentage points, 95%CI -8.2 to 2.2).
Hyperlactatemia appears to arise from impaired oxygen utilization more often than decreased O2 delivery but doesn’t cause acidemia unless there is impaired renal function. The novel “alactic base excess” may give us an early way to tell when the kidneys are failing to compensate.
Peripheral perfusion guided resuscitation was better than lactate clearance in patients with septic shock in regard to improving organ dysfunction at 72 hours (SOFA score) and barely missed statistical significance in reducing 28-day mortality.
In this large cohort study of over 1.8 million pregnancies, first trimester ondansetron use was not associated with cardiac malformations or total congenital malformations. However, there was a small increased risk of oral clefts (3 additional cases per 10,000 women treated).
Treating skin and soft tissue abscesses with antibiotics in addition to incision and drainage (I&D) resulted in significantly increased clinical cure rate (NNT = 14) and decreased incidence of new lesions (NNT = 10) compared to I&D alone.
”Tachypnea at triage, chronic ulcers, history of MRSA colonization or infection, and cellulitis within the past year,” were the risk factors associated with failure of oral antibiotic therapy for non-purulent cellulitis.
A large observational series with over 4,000 intubations compared succinylcholine vs. rocuronium in rapid sequence intubation and found no association between these two paralytics and first-pass intubation success or peri-intubation adverse effects.