NP-led ICUs don't have higher mortality risk, study says | Corticosteroids may lower lung distress risk in preemies | Group issues revised guidelines on blood transfusions
October 18, 2016
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Critical Care Update
NP-led ICUs don't have higher mortality risk, study says
Research published in Critical Care Medicine found admitting patients to an ICU staffed by nurse practitioners did not lead to increased mortality rates, compared with admission to an ICU staffed by residents. Data show ICU length of stay was longer for NP-staffed ICUs and patients from these units were more likely to be discharged from the hospital to a location other than home.
Physician's Briefing/HealthDay News (10/17) 
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Corticosteroids may lower lung distress risk in preemies
Researchers looked at trial data involving 5,698 women at risk of preterm birth between 34 and 37 weeks of gestation and scheduled for cesarean delivery after 37 weeks and found that their infants had higher odds of respiratory problems. The findings in The BMJ prompted researchers to recommend two shots of steroids for such pregnancies to curb babies' severe respiratory problem risk despite an increased likelihood of developing hypoglycemia.
United Press International (10/17) 
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Medicine in the News
Surgeons separate twins conjoined at the head
Neurosurgeon James Goodrich and plastic surgeon Oren Tepper led an operation at the Children's Hospital at Montefiore Medical Center to separate and reconstruct the heads of twins conjoined at the skull. Veins were separated and tissue expanders were implanted in prior surgeries, and 3D models of the boys' skulls were created.
CNN (10/14) 
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Study: Many end-of-life forms are incomplete, inconsistent
A study showed 69% of end-of-life forms filled out by elderly patients had at least one section that had been left blank, researchers reported in the Journal of the American Medical Directors Association. Researchers said 14% of the forms showed patients wanted to receive only comfort measures, but also showed they wanted to be taken to the hospital and given intravenous fluids or antibiotics, which could lead to unwanted care.
Medscape (free registration) (10/14) 
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Trends and Technology
Partnership to expand use of genetic screening test for newborns
A partnership between Edico Genome and Rady Children's Institute for Genomic Medicine will be extended to expand the use of STAT-seq screening, which tests for almost 4,500 genetic diseases in less than 26 hours. Rady's Stephen Kingsmore said information from the genetic tests, which are finished faster using Edico's Dragen processor, helps medical teams make treatment decisions that affect the lives of critically ill newborns and families.
San Diego Business Journal (10/14) 
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Researchers use EHR data to develop algorithms for HF identification
A study in JAMA Cardiology evaluated five algorithms developed to help identify patients with heart failure during hospitalization using EHR data. Researchers found that an algorithm using logistic regression of clinically relevant data elements and two algorithms with different machine-learning approaches using structured or unstructured data offered the most improved accuracy for HF identification.
Cardiology Advisor (10/13) 
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We must not say every mistake is a foolish one.
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