Therapeutics and clinical risk management
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Ther Clin Risk Manag · Jan 2018
Discrimination ability of the endotracheal tube location using real-time palpation during intubation using an endotracheal tube with a preloaded stylet.
Palpation during intubation could be used as an ancillary method of providing real-time information of the endotracheal tube (ETT) placement before manual ventilation. This study aimed to evaluate the ability to discriminate the ETT location using a modified real-time palpation method with a preloaded stylet during intubation. ⋯ The real-time palpation method during intubation using an ETT with a preloaded stylet is an instantly applicable technique with good discrimination ability. The addition of real-time information through this palpation method to the conventional intubation process, especially in patients with poor vocal cord visualization, would be useful to facilitate the process of safe and careful endotracheal intubation.
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Ther Clin Risk Manag · Jan 2018
ReviewAngiotensin II: a new therapeutic option for vasodilatory shock.
Angiotensin II (Ang II), part of the renin-angiotensin-aldosterone system (RAS), is a potent vasoconstrictor and has been recently approved for use by the US Food and Drug Administration in high-output shock. Though not a new drug, the recently published Angiotensin II for the Treatment of High Output Shock (ATHOS-3) trial, as well as a number of retrospective analyses have sparked renewed interest in the use of Ang II, which may have a role in treating refractory shock. ⋯ Evidence suggests that Ang II may preferentially be of benefit in acute kidney injury and acute respiratory distress syndrome, where the RAS is known to be disrupted. Additionally, there may be a role for Ang II in cardiogenic shock, angiotensin converting enzyme inhibitor overdose, cardiac arrest, liver failure, and in settings of extracorporeal circulation.
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Ther Clin Risk Manag · Jan 2018
The impact of introducing the early warning scoring system and protocol on clinical outcomes in tertiary referral university hospital.
The aim of this study was to evaluate the impact of a hospital protocol in response to patient deterioration in general wards, stratified using the national early warning score (NEWS), on primary patient outcomes of in-hospital mortality and percentage of patients transferred to the intensive care unit (ICU). ⋯ Implementing the NEWS with the hospital protocol did not change the overall patient's outcomes.
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Ther Clin Risk Manag · Jan 2018
ReviewAbiraterone acetate for early stage metastatic prostate cancer: patient selection and special considerations.
In recent years, therapeutic advances, together with new medication sequences and combinations, have improved outcomes for prostate cancer. For a long time, androgen deprivation therapy (ADT) has been the standard of care for newly diagnosed, metastatic prostate cancer, first as a standalone therapy and then in combination with taxane-based regimens. ⋯ In this review, we summarize recent findings on the early use of abiraterone in mHSPC and discuss survival benefits as reported in clinical trials. On the basis of existing data, abiraterone in combination with ADT could be considered a new standard of care for patients affected by mHSPC.
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Ther Clin Risk Manag · Jan 2018
Influence of stroke volume variation on fluid treatment and postoperative complications in thoracic surgery.
Fluid management in critically ill patients usually relies on increasing preload to augment cardiac output. In the present study, we aimed to evaluate whether stroke volume variation (SVV) can guide fluid therapy and reduce complications. ⋯ Our study results showed that the use of SVV increased the use of crystalloids and colloids and favorably affected urine output per hour but did not reduce complications in thoracic surgery.