October 2018 Briefing - Critical Care

Here are what the editors at HealthDay consider to be the most important developments in Critical Care for October 2018. 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.

AMA Announces Initiative to Reinvent Physician Training

TUESDAY, Oct. 30, 2018 (HealthDay News) -- The American Medical Association (AMA) today announced a new $15 million competitive grant initiative, the "Reimagining Residency" initiative, aimed at improving residency training.

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Many Hospitals Noncompliant With Record Request Regulations

MONDAY, Oct. 29, 2018 (HealthDay News) -- Among top-ranked U.S. hospitals, data reveal discrepancies in information provided to patients regarding medical records release processes as well as noncompliance with state and federal regulations, according to a study published online Oct. 5 in JAMA Network Open.

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In Complicated UTI, Cefiderocol Noninferior to Imipenem-Cilastin

MONDAY, Oct. 29, 2018 (HealthDay News) -- For complicated urinary tract infections caused by multidrug-resistant Gram-negative uropathogens, the siderophore cephalosporin cefiderocol is non-inferior to imipenem-cilastatin, according to a study published online Oct. 25 in The Lancet Infectious Diseases.

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Trump Administration Announces Plan to Cut Drug Prices

FRIDAY, Oct. 26, 2018 (HealthDay News) -- In an effort to cut high drug costs, the prices paid by Medicare for certain prescription drugs would be based on those in other advanced industrial nations, according to a proposal announced Oct. 25 by the Trump administration.

HHS Study
New York Times Article

Oxygen Saturation Should Not Top 96 Percent in Acutely Ill

THURSDAY, Oct. 25, 2018 (HealthDay News) -- For acutely ill patients, an oxygen saturation of no more than 96 percent should be maintained, according to a clinical practice guideline published online Oct. 24 in the BMJ.

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Neither Haloperidol, Ziprasidone Shortens Delirium in ICU

THURSDAY, Oct. 25, 2018 (HealthDay News) -- For patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the intensive care unit, neither haloperidol nor ziprasidone alters the duration of delirium compared with placebo, according to a study published online Oct. 22 in the New England Journal of Medicine.

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Pace of Change Has Accelerated in Alternative Payment Models

THURSDAY, Oct. 25, 2018 (HealthDay News) -- The impact of alternative payment models (APMs) on physician practices has been described in a study published by the RAND Corp. and the American Medical Association.

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Myo-Inositol Does Not Reduce Retinopathy of Prematurity

WEDNESDAY, Oct. 24, 2018 (HealthDay News) -- Treatment with myo-inositol for up to 10 weeks does not reduce the risk for type 1 retinopathy of prematurity (ROP) or death versus placebo for premature infants younger than 28 weeks of gestational age, according to a study published in the Oct. 23/30 issue of the Journal of the American Medical Association.

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White House Unveils New Insurance Option for Small Firms

TUESDAY, Oct. 23, 2018 (HealthDay News) -- A plan to allow small businesses to use tax-free accounts to provide health coverage for employees was announced today by the Trump administration.

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Intensive SBP Tx Cuts Kidney Damage Biomarkers in Incident CKD

TUESDAY, Oct. 23, 2018 (HealthDay News) -- Patients with incident chronic kidney disease (CKD) in the setting of intensive systolic blood pressure (SBP) treatment have decreases rather than increases in kidney damage biomarkers, according to a study published online Oct. 23 in the Annals of Internal Medicine.

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Bioinformatics Tool Can ID Source of Bloodstream Pathogens

FRIDAY, Oct. 19, 2018 (HealthDay News) -- A streamlined bioinformatics tool can match bloodstream pathogens to a candidate source, according to a study published online Oct. 15 in Nature Medicine.

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Clostridium difficile Spores Survive Laundering of Sheets

WEDNESDAY, Oct. 17, 2018 (HealthDay News) -- Clostridium difficile spores are able to survive laundering through a commercial washer extractor, according to a study published online Oct. 16 in Infection Control & Hospital Epidemiology.

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Procurement Requirements Drive Interoperability in Health Care IT

THURSDAY, Oct. 18, 2018 (HealthDay News) -- Interoperability of health care information technology (IT) must be improved to facilitate creation of a fully integrated health care system that can improve health and health care at lower cost, according to a report published by the National Academy of Medicine.

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Recommendations Developed to Verify NGT Placement in Children

WEDNESDAY, Oct. 17, 2018 (HealthDay News) -- Recommendations on best practices for nasogastric tube (NGT) placement and verification in pediatric patients have been developed. The best practice recommendations were published online Sept. 6 in Nutrition in Clinical Practice.

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CDC Warns of Polio-Like Virus Striking More U.S. Children

TUESDAY, Oct. 16, 2018 (HealthDay News) -- A rare but devastating polio-like virus appears to have made itself at home in the United States, partially paralyzing hundreds of children.

HealthDay Article
More Information: CDC

2006 to 2015 Saw Decrease in Medicare Beneficiary ICU Use

TUESDAY, Oct. 16, 2018 (HealthDay News) -- From 2006 to 2015, there was a significant decrease in intensive care unit (ICU) admissions among Medicare fee-for-service beneficiaries, according to a research letter published online Oct. 15 in the Annals of Internal Medicine.

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Without Medicaid Expansion, Poor Patients Forgo Medical Care

MONDAY, Oct. 15, 2018 (HealthDay News) -- Doing without medical care is much more common among low-income residents of states that have not expanded Medicaid than among low-income people in other states, according to a Government Accountability Office report.

AP News Article

Hospitalization Tied to Brain Abnormalities in Older Adults

MONDAY, Oct. 15, 2018 (HealthDay News) -- Hospitalization is associated with lower white matter integrity among older adults, according to a study published online Sept. 24 in the Journal of the American Geriatrics Society.

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FDA Approves New DNA-Based Test to Verify Blood Compatibility

FRIDAY, Oct. 12, 2018 (HealthDay News) -- The U.S. Food and Drug Administration has approved the ID CORE XT DNA-based test to help doctors verify blood compatibility before a transfusion.

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Nine Cases of Polio-Like Illness Suspected in Children in Illinois

THURSDAY, Oct. 11, 2018 (HealthDay News) -- Nine recent cases of a rare, polio-like disorder in children are being investigated in Illinois, health officials said yesterday.

CNN Article
More Information: CDC

Poor Outcomes for Hispanic Infants With Congenital Heart Dz

THURSDAY, Oct. 11, 2018 (HealthDay News) -- For live-born infants with hypoplastic left heart syndrome (HLHS) and d-transposition of the great arteries (TGA), Hispanic ethnicity is associated with poor outcome, according to a study published online Oct. 10 in the Journal of the American Heart Association.

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Low Recurrence With Shortened IV Abx Course in GBS Bacteremia

THURSDAY, Oct. 11, 2018 (HealthDay News) -- For infants with uncomplicated, late-onset group B Streptococcus (GBS) bacteremia, a shortened intravenous (IV) course of antibiotic therapy is sometimes prescribed and is associated with low rates of disease recurrence and treatment failure, according to a study published online Oct. 11 in Pediatrics.

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Renal-Replacement Timing Has No Effect in Kidney Injury, Sepsis

WEDNESDAY, Oct. 10, 2018 (HealthDay News) -- For patients with early-stage septic shock and severe acute kidney injury, 90-day mortality does not differ for patients randomly assigned to an early strategy for initiation of renal-replacement therapy versus a delayed strategy, according to a study published in the Oct. 11 issue of the New England Journal of Medicine.

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Aetna-CVS Merger Approved

WEDNESDAY, Oct. 10, 2018 (HealthDay News) -- A $69 billion merger between health insurer Aetna and pharmacy manager CVS Health has been approved, according to the U.S. Justice Department.

The New York Times Article

Albuminuria Linked to Incident Lung Function Decline

WEDNESDAY, Oct. 10, 2018 (HealthDay News) -- Albuminuria is associated with incident lung function decline and chronic obstructive pulmonary disease (COPD), according to a study published online Sept. 28 in the American Journal of Respiratory and Critical Care Medicine.

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Polio-Like Condition in Children on Rise Again in the United States

TUESDAY, Oct. 9, 2018 (HealthDay News) -- A rare, polio-like condition in children is on the rise again in the United States, with 38 confirmed cases in 16 states so far this year, the U.S. Centers for Disease Control and Prevention says.

NBC News Article
More Information: CDC

Mechanical Ventilation May Alter Diaphragm Muscle Fibers

TUESDAY, Oct. 9, 2018 (HealthDay News) -- In critically ill patients, mechanical ventilation with positive end-expiratory pressure (PEEP) results in reduced diaphragm fiber length that may make it more difficult to wean patients from mechanical ventilation, according to a study published in the Aug. 15 issue of the American Journal of Respiratory and Critical Care Medicine.

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Minority Residents Experience Burdens Linked to Race/Ethnicity

TUESDAY, Oct. 9 2018 (HealthDay News) -- Minority residents describe burdens associated with race/ethnicity, including microaggressions and bias on a daily basis, according to a study published online Sept. 28 in JAMA Network Open.

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Industry-Funded Trials Often Involve Employees in Studies

FRIDAY, Oct. 5, 2018 (HealthDay News) -- Industry employees are often involved in the design, conduct, and reporting of industry-funded trials in high-impact journals, according to a study published online Oct. 3 in The BMJ.

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One-Third of Older Adults Die After Emergency Intubation

FRIDAY, Oct. 5, 2018 (HealthDay News) -- Of older adults who undergo intubation in the emergency department, 33 percent die during the index hospitalization, according to a study published recently in the Journal of the American Geriatrics Society.

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Models Predict Intracerebral Hemorrhage Growth

FRIDAY, Oct. 5, 2018 (HealthDay News) -- Models using four or five predictors have acceptable to good discrimination for determining additional intracerebral hemorrhage growth in patients with acute intracerebral hemorrhage, according to a review published in the October issue of The Lancet Neurology.

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No Increase in In-Hospital, Post-Discharge Death With HRRP

FRIDAY, Oct. 5, 2018 (HealthDay News) -- Announcement and implementation of the Hospital Readmissions Reduction Program (HRRP) was not associated with increases in in-hospital or post-discharge mortality after acute myocardial infarction (AMI), heart failure, or pneumonia, according to a study published online Sept. 28 in JAMA Network Open.

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Number of COPD Events Over One Year Predicts Rate of Future Events

THURSDAY, Oct. 4, 2018 (HealthDay News) -- The frequency of acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) in a single year predicts the long-term rate of AECOPDs, according to a study recently published in the American Journal of Respiratory and Critical Care Medicine.

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Tips Provided for Budgeting in Medical Residency

THURSDAY, Oct. 4, 2018 (HealthDay News) -- Medical residents should start budgeting and save for the future, according to an article published in the American Medical Association AMA Wire.

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Price Hikes Noted in Small Subset of Generic Drugs

THURSDAY, Oct. 4, 2018 (HealthDay News) -- A small but growing subset of generic drugs experienced sudden large price increases from 2007 to 2013, according to a study published in the October issue of Health Affairs.

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Three-Quarters of Health Care Workers Got Flu Shot Last Year

THURSDAY, Oct. 4, 2018 (HealthDay News) -- Just over three-quarters of health care personnel received a flu vaccine last season, according to research published in the Sept. 28 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Uninsured Rate at 8.8 Percent in First Quarter of 2018

WEDNESDAY, Oct. 3, 2018 (HealthDay News) -- In the first quarter of 2018, the uninsured rate was 8.8 percent, not significantly different from a year earlier, according to a report released Aug. 29 by the National Center for Health Statistics (NCHS).

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Preventable Cardiovascular Events Are Big Economic Burden

TUESDAY, Oct. 2, 2018 (HealthDay News) -- Preventable cardiovascular events place a considerable health and economic burden on the United States, according to research published in the Sept. 7 issue of the U.S. Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report.

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For Employer-Based Plans, Spending Across Services Steady

TUESDAY, Oct. 2, 2018 (HealthDay News) -- Despite large health policy changes, the distribution of spending across service areas has remained fairly consistent over the past 10 years for those enrolled in employer-sponsored insurance, according to a study published in the October issue of Health Affairs.

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Blacks Less Likely to Receive Guideline-Based NSTEMI Therapy

TUESDAY, Oct. 2, 2018 (HealthDay News) -- Black patients have a lower likelihood of receiving guideline-based therapies for non-ST-segment-elevation myocardial infarction (NSTEMI), according to a study published online Sept. 20 in the Journal of the American Heart Association.

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Interviews Can Help Ensure Physician Candidates Fit Culture

TUESDAY, Oct. 2, 2018 (HealthDay News) -- In preparing to interview to hire a new physician, practices must understand their own cultures, according to an article published in Medical Economics.

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Number of Health-Related Data Breaches Increasing

TUESDAY, Oct. 2, 2018 (HealthDay News) -- The number of health data breaches has steadily increased since 2010, according to a research letter published in the Sept. 25 issue of the Journal of the American Medical Association.

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Hospital Privacy Curtains Become Increasingly Contaminated

MONDAY, Oct. 1, 2018 (HealthDay News) -- Curtains surrounding patient beds become progressively contaminated with bacteria, according to a study published in the September issue of the American Journal of Infection Control.

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Risk of Venous Thromboembolism Recurrence High

MONDAY, Oct. 1, 2018 (HealthDay News) -- The risk of recurrence after incident venous thromboembolism is high, particularly among patients with cancer-related venous thromboembolism, according to a study published in the September issue of The American Journal of Medicine.

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More Non-Elderly Americans Uninsured in 2017 Versus 2016

MONDAY, Oct. 1, 2018 (HealthDay News) -- From 2016 to 2017, there was an increase in the number of uninsured non-elderly Americans, according to a report published by the Robert Wood Johnson Foundation.

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