Emergencias
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Multicenter Study Comparative Study
Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment.
Paracetamol poisoning can be serious and require treatment with N-acetylcysteine (NAC). A dose of 300 mg/kg is usually given in 3 fractions over 21 hours. An alternative regimen, the Scottish and Newcastle Acetylcysteine Protocol (SNAP), specifies the same total dose given in 2 intravenous injections over 12 hours. This study aimed to compare the 2 regimens in terms of effectiveness, adverse events, and lengths of emergency department (ED) and hospital stays. ⋯ Fewer adverse events occurred with the SNAP approach. The 2 protocols were similarly effective. The SNAP-treated patients spent less time in the ED, and those who were admitted to hospital had shorter stays.
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To analyze the possible association between a finding of plasma alkalosis in patients diagnosed with acute heart failure (AHF) in the emergency department (ED) and in-hospital mortality. ⋯ This retrospective analysis of cases in the EAHFE registry found no association between alkalosis and higher in-hospital mortality after AHF. Nor were significant associations found when we analyzed mortality related to probable metabolic vs respiratory alkalosis.
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Multicenter Study
Scale to predict risk for refractory septic shock based on a hybrid approach using machine learning and regression modeling.
To develop a scale to predict refractory septic shock (SS) based on clinical variables recorded during initial evaluations of patients. ⋯ The RSSS had adequate diagnostic accuracy in multiple cohorts of patients diagnosed in the ED and ICU.