July 2019 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for July 2019. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Burnout Symptoms May Up Racial Bias Among Resident Physicians

WEDNESDAY, July 31, 2019 (HealthDay News) -- Symptoms of burnout seem to be associated with greater explicit and implicit racial bias among resident physicians, according to a study published online July 26 in JAMA Network Open.

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$70 Million Settlement Reached in Generic Drug Delay Case

TUESDAY, July 30, 2019 (HealthDay News) -- Three drug companies will pay a total of nearly $70 million to California to settle charges of delaying the sale of generic drugs to keep brand-name drug prices high, the state's attorney general said Monday.

AP News Article

National Norms Developed for Assessing Medical School Empathy

TUESDAY, July 30, 2019 (HealthDay News) -- National norms have been developed for assessing empathy among men and women at different levels of medical school education, according to a study published in the August issue of the Journal of the American Osteopathic Association.

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N.C. Man Dies of Brain-Eating Amoeba After Visiting Water Park

MONDAY, July 29, 2019 (HealthDay News) -- The rare brain-eating amoeba Naegleria fowleri has been confirmed as the cause of death of a North Carolina man.

CBS News Article
More Information: CDC

Pediatricians Have Role to Play in Addressing Racism

MONDAY, July 29, 2019 (HealthDay News) -- Pediatricians should play a role in advocating to redress biases and inequalities in the health system and other systems, according to a policy statement published online July 29 in Pediatrics.

Policy Statement
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Model Fails to Predict Risk for Maternal ICU Admission

FRIDAY, July 26, 2019 (HealthDay News) -- A predictive model that uses prenatal risk factors to help identify women at higher risk for admission to the maternal intensive care unit (ICU) has low positive predictive value, according to a study published online July 9 in Obstetrics & Gynecology.

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Exposure to Air Pollution Tied to Raised Odds of NICU Admission

THURSDAY, July 25, 2019 (HealthDay News) -- Acute exposure to pollutants in the week prior to delivery and day of delivery is associated with increased odds of neonatal intensive care unit (NICU) admission, according to a study published online July 12 in the Annals of Epidemiology.

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Review Examines Methods for Diagnosis of Elevated ICP in Critically Ill

THURSDAY, July 25, 2019 (HealthDay News) -- Physical examination signs are not sufficiently sensitive for detecting elevated intracranial pressure (ICP) in critically ill adults, according to a review published online July 24 in The BMJ.

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No Indication of 'July Effect' in Context of Cardiac Surgery

THURSDAY, July 25, 2019 (HealthDay News) -- In the context of cardiac surgery, there is no indication of a "July effect," describing worse outcomes in the first month of training, according to a study published online July 25 in the Annals of Thoracic Surgery.

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In-Hospital Cardiac Arrests in the U.S. May Be Underestimated

WEDNESDAY, July 24, 2019 (HealthDay News) -- More patients suffer cardiac arrest in U.S. hospitals each year than previously estimated -- with rates about 38 percent greater for adults and 18 percent greater for children, according to a study published online July 9 in Circulation: Cardiovascular Quality and Outcomes.

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About One in 20 Patients Exposed to Preventable Harm

THURSDAY, July 18, 2019 (HealthDay News) -- The pooled prevalence of preventable patient harm is 6 percent across a range of medical settings globally, according to a review published online July 17 in The BMJ.

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Recarbrio OK'd for Complicated Urinary Tract, Intra-Abdominal Infections

WEDNESDAY, July 17, 2019 (HealthDay News) -- The antibacterial drug product Recarbrio (imipenem, cilastatin, and relebactam) has been approved to treat complicated urinary tract infections (cUTI) and complicated intra-abdominal infections (cIAI) in adults, the U.S. Food and Drug Administration announced today.

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Intranasal Sufentanil Cuts Acute Trauma Pain Treated in the ED

WEDNESDAY, July 17, 2019 (HealthDay News) -- Intranasal sufentanil (INS) is comparable to intravenous morphine (IVM) for acute severe trauma pain treated in the emergency department, according to a study published online July 16 in PLOS Medicine.

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Early EEG Helps Predict Cardiac Arrest Outcomes in Comatose

WEDNESDAY, July 17, 2019 (HealthDay News) -- Early electroencephalography (EEG) reliably predicts the outcome of comatose patients after cardiac arrest, according to a study recently published in the Annals of Neurology.

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Protocolized Sepsis Care Lowers Sepsis Mortality in NY State

TUESDAY, July 16, 2019 (HealthDay News) -- State-mandated protocolized sepsis care is associated with a greater decrease in sepsis mortality compared with that seen in states not implementing sepsis regulations, according to a study published in the July 16 issue of the Journal of the American Medical Association.

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Flexible Family Visitation Policy Does Not Cut Delirium in ICU

TUESDAY, July 16, 2019 (HealthDay News) -- Compared with standard restricted visiting hours, a flexible family visitation policy does not significantly reduce the incidence of delirium among patients in the intensive care unit (ICU), according to a study published in the July 16 issue of the Journal of the American Medical Association.

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Race, Neighborhood Impact Bystander CPR in Pediatric OHCA

MONDAY, July 15, 2019 (HealthDay News) -- For pediatric out-of-hospital cardiac arrest (OHCA), racial and neighborhood characteristics are associated with bystander cardiopulmonary resuscitation (BCPR), according to a study published online July 10 in the Journal of the American Heart Association.

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Serious Misdiagnosis-Related Harms Mostly Due to 'Big Three'

FRIDAY, July 12, 2019 (HealthDay News) -- Vascular events, infections, and cancers account for about three-quarters of serious misdiagnosis-related harms, according to a study published online July 11 in Diagnosis.

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Capping Work Hours in Residency Does Not Impact Outcomes Later

THURSDAY, July 11, 2019 (HealthDay News) -- Exposure of U.S. physicians to work-hour reforms during residency training is not associated with post-training differences in patient mortality, readmissions, or costs of care, according to a study published online July 11 in The BMJ.

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PE, Death Not Reduced With Early Vena Cava Filter Placement

THURSDAY, July 11, 2019 (HealthDay News) -- Early prophylactic placement of a vena cava filter compared with no placement of a filter after major trauma does not result in a reduced incidence of symptomatic pulmonary embolism or death at 90 days, according to a study published online July 7 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the International Society on Thrombosis and Haemostasis, held from July 6 to 10 in Melbourne, Australia.

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Health Care Professionals Exhibit Gender Bias

THURSDAY, July 11, 2019 (HealthDay News) -- Survey results show that health care professionals have implicit and explicit gender bias, according to a study published online July 5 in JAMA Network Open.

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CDC Updates Data on Cases Meeting Criterion for Acute Flaccid Myelitis

TUESDAY, July 9, 2019 (HealthDay News) -- Clinical and laboratory data have been updated for cases that met the clinical criterion for acute flaccid myelitis (AFM) in the United States during 2018, according to a Vital Signs report published in the July 9 early-release issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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EHR System-Generated In-Basket Messages Linked to Burnout

TUESDAY, July 9, 2019 (HealthDay News) -- Receipt of more than the average number of electronic health record (EHR) system-generated in-basket messages is associated with an increased probability of physician burnout, according to a study published in the July 1 issue of Health Affairs.

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Shorter ICU Rotations Cut Physician Burnout

TUESDAY, July 2, 2019 (HealthDay News) -- Shorter rotations in intensive care units can mitigate burnout among physicians, according to a study published online June 25 in the American Journal of Respiratory and Critical Care Medicine.

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Many Nurses Believe in Sedation for Comfort of Ventilated Patients

TUESDAY, July 2, 2019 (HealthDay News) -- More than half of critical care nurses believe sedation is needed to minimize discomfort and distress among patients receiving mechanical ventilation, according to survey results published in the July issue of the American Journal of Critical Care.

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Considerable Number of Patients Receive Surprise Hospital Charges

TUESDAY, July 2, 2019 (HealthDay News) -- Eighteen percent of all emergency department visits and 16 percent of in-network hospital stays have at least one out-of-network charge, according to a report published June 20 by the Kaiser Family Foundation.

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