Mobilizing ICU Patients May Not Affect Risk of Adverse Events, Death
Mobilizing patients who required mechanical ventilation in the intensive care unit (ICU) was associated with a less than 3% risk of adverse events such as falls, desaturation, and hemodynamic instability, a systematic review and meta-analysis found. Compared with usual care, very-low-certainty evidence showed that mobilization did not lead to adverse events (risk ratio [RR] 1.09, […]
Tailoring Drug Interaction Alerts to the ICU Reduced Number of High-Risk Combos
PHOENIX — Tailoring potential drug-drug interaction (DDI) alerts to the intensive care unit (ICU) setting significantly reduced the number of administered high-risk drug combinations, a cluster randomized stepped-wedge trial showed. Among nearly 10,000 patients admitted to the ICU, the use of potential DDI alerts tailored to the ICU led to a 12% decrease (95% CI […]
Conservative Oxygenation Outperforms Liberal Targets for Critically Ill Kids
Conservative oxygenation targets in the pediatric intensive care unit (PICU) improved outcomes and reduced costs for ventilated patients, a randomized clinical trial found. The rank-based endpoint of duration of organ support or death before day 30 was significantly lower among children randomized to conservative oxygenation as opposed to liberal targets (probabilistic index 0.53, 95% CI […]
Inhaled Antibiotic Cuts Risk of Ventilator-Associated Pneumonia
A short course of an inhaled antibiotic helped prevent the incidence of ventilator-associated pneumonia in the intensive care unit (ICU), a randomized trial in France showed. In critically ill patients intubated for between 3 to 4 days, administration of amikacin (Arikayce) reduced the rate of first ventilator-associated pneumonia compared with an inhaled placebo (15% vs […]
Intensive Pretransplant Consolidation in Older AML Fails to Improve Results
HOUSTON — Intensive consolidation treatment before allogeneic stem-cell transplant did not improve outcomes in older patients with acute myeloid leukemia (AML), a retrospective comparison showed. Relapse-free survival (RFS) at 2 years was virtually identical for patients who received intensive consolidation therapy (51%) and those who did not (50%). The intensive-therapy group had a trend toward […]
Treating Early Hospitalization Blood Pressure Deemed a No-No for Patient Safety
For older people hospitalized with noncardiovascular diagnoses, intensive lowering of asymptomatic inpatient blood pressures (BPs) may constitute overtreatment and lead to harm, observational data suggested. U.S. veterans acutely treated for elevated systolic BP in the first 48 hours of hospitalization — without evidence of acute end organ damage — suffered more adverse events when counting […]
Adding Mylotarg to Chemo Fails to Boost Survival in NPM1-Mutated AML
There was bad news and good news in a phase III trial evaluating intensive chemotherapy with or without gemtuzumab ozogamicin (Mylotarg) in acute myeloid leukemia (AML) patients with newly diagnosed, NPM1-mutated disease. For the primary endpoints of event-free survival (EFS) and overall survival (OS), the gemtuzumab ozogamicin-treated group experienced no benefit, but addition of the […]
Probiotic Use in NICUs Shows Some Benefits in Newborns With Very Low Birth Weight
Routine use of probiotics among newborns with very low birth weight in U.S. neonatal intensive care units (NICUs) was associated with a lower risk of necrotizing enterocolitis, but not sepsis or mortality, according to a cohort study. Among over 300,000 newborns, the incidence of necrotizing enterocolitis was reduced by 18% at NICUs that adopted use […]
SPRINT BP Control Ups cTn; FH & Eating Disorders; Cardiac Death During ‘Avatar 2’
In SPRINT, intensive systolic blood pressure lowering decreased natriuretic peptide levels but increased high-sensitivity cardiac troponin T (cTn). (Circulation) The medical community braces for harmful messaging about COVID-19 vaccines after Florida Surgeon General Joseph Ladapo, MD, PhD, announced plans for another study on their links to myocarditis. (Orlando Sentinel) As an alternative to high-intensity statin […]
Survival No Better With Intensive Surveillance in Endometrial Cancer
An intensive surveillance regimen for endometrial cancer did not improve overall survival (OS) over a minimalist regimen, even in high-risk patients, results from the randomized TOTEM trial showed. After a median follow-up of 69 months, the 5-year OS rate was 90.6% with the intensive approach versus 91.9% with the minimalist approach, which mainly included physical […]