Using interprofessional collaboration to reduce reported rates of central-line-associated bloodstream infection in an intensive care setting.

Using a multicomponent approach that included blood-culture stewardship, evaluation for secondary sources of bloodstream infection, improved documentation, and prompt central-line removal, an interprofessional team improved patient care and reduced central-line-associated bloodstream infection rates in collaboration with the primary team on the surgical intensive care unit.

Inter-Hospital Transfer Is an Independent Risk Factor for Hospital-Associated Infection.

Regionalization of surgical care shifts higher acuity patients to larger centers. Hospital-associated infections (HAIs) are important quality measures with financial implications. In our ongoing efforts to eliminate HAIs, we examined the potential role for inter-hospital transfer in our cases of HAI across a multihospital system.

Prescribing Habits of Providers and Risk Factors for Nonadherence to Opioid Prescribing Guidelines.

Background: The Michigan Opioid Prescribing Engagement Network introduced guidelines in October 2017 to combat opioid overprescription following various surgical procedures. We sought to evaluate changes in opioid prescribing at our academic center and identify factors associated with nonadherence to recently implemented opioid prescribing guidelines.

Methods: This retrospective review analyzed opioid prescribing data for appendectomy, cholecystectomy, and hernia repair from January 2015 through September 2017 (pre-guidelines group) and November 2017 through December 2018 (post-guidelines group).

Lung Transplantation for the Treatment of Vaping-Induced, Irreversible, End-Stage Lung Injury.

Recently, there has been a rise in the incidence of E-cigarette/Vaping-Associated Lung Injury (EVALI) in the United States, mostly involving tetrahydrocannabinol. Current treatment strategies for EVALI are aimed at controlling the inflammatory and infectious causes, in addition to supportive care. Although most patients improve with supportive measures, the long-term pulmonary effects of this illness are still not well defined.

Necrotizing pancreatitis: A review for the acute care surgeon.

Background: Necrotizing pancreatitis is a common condition with high mortality; the acute care surgeon is frequently consulted for management recommendations. Furthermore, there has been substantial change in the timing, approach, and frequency of surgical intervention for this group of patients.

Methods: In this article we summarize key clinical and research developments regarding necrotizing pancreatitis, including current recommendations for treatment of patients requiring intensive care and those with common complications.

Challenging the Surgical Axiom: Albumin Level Does Not Reliably Predict Development of Wound Complications in Patients Undergoing Body Contouring.

Introduction: Hypoalbuminemia has traditionally been associated with a poor nutritional status and subsequent high incidence of postoperative wound complications in surgical patients. Recent evidence, however, suggests that traditional nutritional markers are inadequate in predicting postoperative morbidity.

Objective: To test the hypothesis that preoperative albumin levels are not associated with adverse outcomes in patients undergoing body contouring.

PADUA score as a predictor for pulmonary embolism: a potential strategy for reducing unnecessary imaging.

An objective tool that is easy to integrate with an electronic medical record may help reduce unnecessary imaging for diagnosing a pulmonary embolism (PE). In this study, we assess the PADUA score in stratifying patients based on their risk of a PE. We reviewed charts of patients that underwent a computed tomography pulmonary angiogram (CT-PA) between January 2014 and September 2015 at our institution.

Clostridium Difficile-Associated Infection in Trauma Patients: Development of the Clostridium Difficile Influencing Factors (CDIF) Score.

Context: Clostridium difficile-associated infection (CDAI) can result in longer hospitalization, increased morbidity, and higher mortality rates for surgical patients. The impact on trauma patients is unknown, however.

Objective: To assess the effect of CDAI on trauma patients and develop a scoring system to predict CDAI in that population.

Protocolized care for early shock resuscitation.

Purpose Of Review: Protocolized care for early shock resuscitation (PCESR) has been intensely examined over the last decade. The purpose is to review the pathophysiologic basis, historical origin, clinical applications, components and outcome implications of PCESR.

Recent Findings: PCESR is a multifaceted systems-based approach that includes early detection of high-risk patients and interventions to rapidly reverse hemodynamic perturbations that result in global or regional tissue hypoxia.