Adherence to National Consensus Guidelines and Association with Clinical Outcomes in Patients with Candidemia.

Background: National consensus guidelines outline recommendations for best practices in treating patients with candidemia. This study evaluated the impact of receiving care adherent to the best practice recommendations on clinical outcomes in patients with candidemia.

Methods: This retrospective, multicenter study included patients with candidemia from 2010 to 2015 at 9 hospitals.

Evaluation of the Safety of Rapid Parenteral Nutrition Titration.

Background: Initiation of parenteral nutrition (PN) can cause complications including hyperglycemia (HGL), electrolyte abnormalities, and refeeding syndrome (RFS). These concerns lead many to titrate over several days, but our practice is to titrate PN to goal within 8 hours. The aim of this study was to evaluate the safety of titrating PN to goal within 8 hours.

Activated prothrombin complex concentrate for warfarin reversal in traumatic intracranial hemorrhage.

Background: Patients with traumatic intracranial hemorrhage (TIH) anticoagulated with warfarin are at an increased risk of mortality. Fresh frozen plasma (FFP) and vitamin K have been the standard treatment for warfarin reversal; however, guidelines now recommend the use of prothrombin complex concentrate (PCC) for warfarin reversal in patients with life-threatening bleeding. Our protocol uses one vial (∼1000 units) of activated PCC (aPCC) for warfarin reversal, regardless of the weight or presenting international normalized ratio (INR).

Hypocalcemia in trauma patients receiving massive transfusion.

Background: Massive transfusion protocol (MTP) is increasingly used in civilian trauma resuscitation. Calcium is vital for coagulation, but hypocalcemia commonly occurs during massive transfusion due to citrate and serum calcium chelation. This study was conducted to determine the incidence of hypocalcemia and severe hypocalcemia in trauma patients who receive massive transfusion and to compare characteristics of patients with severe versus nonsevere hypocalcemia.

Evaluation of nutrition support pharmacist interventions.

Background: The purpose of this study was to determine the number and types of interventions performed by our nutrition support service (NSS) pharmacists that were not directly related to the nutrition formula prescription.

Methods: This was an institutional review board-approved retrospective study of all adult pharmacy NSS consultations from January 1, 2011 to December 31, 2011. All interventions assessed were categorized as the following: fluids and electrolytes, glucose management, alternate therapy, diagnostics, general laboratory result monitoring, vitamin and trace element monitoring, discontinuing medication, adding medication, dose adjustment, and other.