March 23, 2022
Periop in a pandemic
Without data or guidelines on when and whether to perform surgery on the many patients who have had COVID-19 infections after vaccination, hospitals and hospitalists are developing their own plans and protocols.
Why perioperative anaphylaxis is like paella
An expert speaker at the American Academy of Allergy, Asthma, & Immunology 2022 Annual Meeting drew parallels between perioperative anaphylaxis and the Spanish dish, reviewing differential diagnoses, causal agents, and useful labs.
Advance care planning assessed, therapeutic heparin debated in recent COVID-19 articles
Along with an analysis of the pre-existing conditions of patients who died of COVID-19 and a point/counterpoint on use of heparin in ward patients, the latest inpatient COVID-19 research included negative trials of losartan and a potential monoclonal antibody.
Patients discharged home from ICU had similar outcomes as those transferred to ward
A Canadian study found no difference in hospital readmission or ED visits within 30 days between patients who were discharged directly home after an ICU stay and those who were transferred to a ward before discharge.
Fecal microbiota transplant appears cost-effective for first recurrent C. diff infection
A modeling study found the greatest cost-effectiveness with fidaxomicin for initial nonsevere Clostridioides difficile infection, with vancomycin for initial severe infection, and with fecal microbiota transplant for first and subsequent recurrent infection.
Women less likely to get guideline-recommended care for MI with cardiogenic shock
The analysis of patients admitted with acute myocardial infarction (MI) with cardiogenic shock found higher rates of in-hospital mortality and major bleeding in women compared to men but no difference in mortality or heart failure hospitalizations at one year.