Enteral nutrition is better in Severe Pancreatitis : Another study

H Yao, C He, L Deng, G Liao et el  published in the European Journal of nutrition a meta analysis of small trials, comparing enteral versus parenteral nutrition in cases of severe pancreatitis. They analyzed the evidence from 348 patients from 5 small randomized trials. Meta-analysis showed significantly lower overall mortality risk with EN than with PN (risk ratio, 0.36; …

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ESICM/ESCMID/ALAT guidelines for the management of HAP and VAP

European Respiratory Society (ERS), European Society of Intensive Care Medicine (ESICM), European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and Asociación Latinoamericana del Tórax (ALAT) Recently published guidelines for management of hospital acquired pneumonia(HAP), and ventilator associated pneumonia. These guidelines are sligtly different then presented by IDSA and ATS published in July 2016. Some of the differences in …

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ATS/ESICM/SCCM Guidelines for mechanical ventilation : ARDS

Fan E, Del Sorbo L, Goligher EC, Hodgson CL et el published official guidelines for mechanical ventilation in ARDS which were published recently. Guidelines are in a question answer format and they answer 6 questions. They did not comment on  Airway pressure release ventilation and use of NM blockade. Here is the summary Future studies are needed to resolve following …

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Bundle to reduce ventilator associated events

Nishi Rawat, Ting Yang,  Kisha J. Ali et el  published a two state multifaceted intervention study showing benefits of improved compliance with evidence based practices can reduce ventilator-associated event, infection-related ventilator- associated complication, and probable ventilator-associated pneumonia. It was a longitudinal quasi-experimental study involving 56 ICUs at 38 hospitals in Maryland and Pennsylvania from October 2012 to March 2015. PROBLEM …

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New assay to diagnose late acetaminophen toxicity

Roberts DW, Lee WM, Hinson JA et el published a observational cohort study in Clinical Gastroenterology and Hepatology journal about utility of  point-of-care assay to detect acetaminophen protein adducts in patients suspected to have acetaminophen toxicity. They compared the accuracy of AcetaSTAT vs high-pressure liquid chromatography with electrochemical detection (HPLC-EC; a sensitive and specific quantitative analytic assay) to …

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Another retrospective study proving early antibiotics in sepsis improves mortality

Christopher W. Seymour, Foster Gesten et el published a retrospective study in NEJM looking at impact of implementation of bundle treatment in sepsis. WHAT THEY DID Looked at the data(On patients with sepsis and septic shock, community acquired only) reported to New York Health Department from April 1, 2014, to June 30, 2016. More than 98% of …

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