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ICU Pressures Improve Transfers to the Floor
October 27, 2014
Clinical question: Does ICU strain negatively affect the outcomes of patients transferred to the floor? Background: With healthcare costs increasing and critical care staff shortages projected, ICUs will have to operate under increasing strain.
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Neither Low-Dose Dopamine nor Low-Dose Nesiritide Improves Renal Dysfunction in Acute Heart Failure Patients
October 27, 2014
Clinical question: Does low-dose dopamine or low-dose nesiritide added to diuretic therapy enhance pulmonary volume reduction and preserve renal function in patients with acute heart failure and renal dysfunction, compared to placebo? Background: Small studies have suggested that low-dose dopamin
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Beta Blockers Lower Mortality after Acute Myocardial Infarction in COPD Patients
October 27, 2014
Clinical question: Does the use and timing of beta blockers in COPD patients experiencing a first myocardial infarction (MI) affect survival after the event? Background: Beta blockers are effective in reducing mortality and reinfarction after an MI; however, concerns regarding the side effects of
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Edoxaban Is Noninferior to Warfarin in Patients with Atrial Fibrillation
October 27, 2014
Clinical question: What is the long-term efficacy and safety of edoxaban compared with warfarin in patients with atrial fibrillation (Afib)? Background: Edoxaban is an oral factor Xa inhibitor approved for use in Japan for the prevention of venous thromboembolism after orthopedic surgery.
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Interdisciplinary Intervention Improves Medication Compliance, Not Blood Pressure or LDL-C Levels
October 27, 2014
Clinical question: Can intervention by pharmacists and physicians improve compliance to cardio-protective medications? Background: Adherence to cardio-protective medications in the year after hospitalization for acute coronary syndrome is poor. Study design: RCT. Setting: Four Department of
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Colloids vs. Crystalloids for Critically Ill Patients Presenting with Hypovolemic Shock
October 27, 2014
Clinical question: In critically ill patients admitted to the ICU with hypovolemic shock, does the use of colloid for fluid resuscitation, compared with crystalloid, improve mortality? Background: The current Surviving Sepsis Campaign guidelines recommend crystalloids as the preferred fluid for r
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“Triple Rule Outs” for Chest Pain: A Tool to Evaluate the Coronaries but Not Pulmonary Embolism or Aortic Dissection
October 27, 2014
Clinical question: How does “triple rule out” (TRO) computed tomographic (CT) angiography compare to other imaging modalities in evaluating coronary and other life-threatening etiologies of chest pain, such as pulmonary embolism (PE) and aortic dissection? Background: TRO CT angiography is a noni
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Patients Prefer Inpatient Boarding to Emergency Department Boarding
October 27, 2014
Clinical question: Do patients who experience overcrowding and long waits in the emergency department (ED) prefer boarding within ED hallways or within inpatient medical unit hallways? Background: Boarding of admitted patients in EDs can be problematic, especially with regard to patient safety an
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Benefit of Therapeutic Hypothermia after Cardiac Arrest Unclear
October 27, 2014
Clinical question: Does targeted hypothermia (33°C) after cardiac arrest confer benefits compared with targeted temperature management at 36°C? Background: Therapeutic hypothermia is a current recommendation in resuscitation guidelines after cardiac arrest.
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Pre-Operative Beta Blockers May Benefit Some Cardiac Patients
October 27, 2014
Clinical question: In patients with ischemic heart disease (IHD) undergoing non-cardiac surgery, do pre-operative beta blockers reduce post-operative major cardiovascular events (MACE) or mortality at 30 days? Background: Peri-operative beta blocker use has become more restricted, as evidence abo