Study: Aggressive treatment may not improve septic shock outcomes | Enterobacteriaceae bacteraemia raises daily risk of death in ICU | Dexmedetomidine may not benefit sepsis patients on ventilator
March 24, 2017
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Study: Aggressive treatment may not improve septic shock outcomes
Early goal-directed therapy for treating septic shock did not reduce mortality or resource utilization but did increase ICU care and cardiovascular support, compared with regular care, researchers reported in the New England Journal of Medicine.
MedPage Today (free registration) (3/23) 
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Enterobacteriaceae bacteraemia raises daily risk of death in ICU
A study of two ICUs in England found providing appropriate empiric antibiotic treatments to patients with ICU-acquired Enterobacteriaceae bacteraemia did not affect mortality rates. The study in the Journal of Hospital Infection linked Enterobacteriaceae bacteraemia to higher daily risks for ICU death and a lower likelihood of daily ICU discharge. (3/21) 
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Medicine in the News
Joint Commission's sentinel events report shows few changes
The Joint Commission's list of the 10 most common sentinel events for 2016 is similar to the 2015 list, but the group reviewed slightly fewer events: 824, down from 936 in 2015. Dialysis-related events and perinatal death/injury came off the list, replaced by medication errors and criminal events, with unintended retention of a foreign body as the most-recorded event. (3/15) 
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Mortality drops when hospitals are being inspected, research finds
A study in JAMA Internal Medicine found that patient mortality is lower when Joint Commission inspectors are assessing a hospital than in the weeks before and after the visit. Researchers attribute the quality improvement, which translated to 1.5% lower 30-day mortality overall and a 5.9% reduction at major teaching hospitals, to greater overall vigilance, rather than specific measures.
STAT (tiered subscription model) (3/20) 
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Trends and Technology
Researchers create tool to track delirium severity
Indiana University researchers developed a tool to track delirium severity in ICU patients, including those on mechanical ventilation, according to a study in Critical Care Medicine. The Confusion Assessment Method for the Intensive Care Unit 7 uses a scale of zero to seven to rate delirium severity in patients. (3/19) 
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Study IDs way to reduce bacterial growth on medical devices
A study in the Proceedings of the National Academy of Sciences found targeting the SdrC protein in Staphylococcus aureus bacteria may help prevent bacterial growth on medical devices, including catheters, replacement heart valves and artificial joints. Laboratory experiments showed using neurexin peptides on the SdrC protein reduced its ability to link cells and promote bacterial growth. (3/21) 
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