Impact of Clinical, Unit-Specific Guidelines on Dornase Alfa Use in Critically Ill Pediatric Patients Without Cystic Fibrosis.

The purpose of this study was to evaluate the impact of the implementation of pharmacist-guided, unit-specific dornase alfa utilization guidelines for patients without cystic fibrosis in an academic medical institution. The study reviewed the prescribing patterns in the institution's pediatric intensive care unit (PICU) and pediatric cardiac intensive care unit (PCICU) before and after the implementation of these guidelines. The primary objective of this study was to determine the effects of the guidelines on the number of dornase alfa doses prescribed in critically ill pediatric patients without cystic fibrosis.

Treatment with Foscarnet after Allogeneic Hematopoietic Cell Transplant (Allo-HCT) Is Associated with Long-Term Loss of Renal Function.

Despite a well-established risk of chronic kidney disease (CKD) after allogeneic hematopoietic cell transplant (allo-HCT), the benefits of using nephrotoxic anti-infective agents to treat serious peritransplant infections often outweigh this risk. While there is no consensus on the optimal management of post-allo-HCT human herpes virus 6 (HHV6) reactivation, the nephrotoxic drug foscarnet is often used, although its long-term impact on renal function has not been established. We retrospectively reviewed 987 adult patients who underwent transplantation between 2002 and 2016, of whom 45.

Evaluation of Rescue Thrombolysis in Cardiac Arrest Secondary to Suspected or Confirmed Pulmonary Embolism.

Background: Pulmonary embolism (PE) is the associated cause of unexplained cardiac arrest in 5% to 13% of patients. Although thrombolytic agents have been studied, patient outcomes during cardiac arrest are lacking.

Objective: The purpose of this study was to describe outcomes of patients who received thrombolytic therapy during cardiac arrest for suspected or confirmed PE.

Management of Anticoagulant and Antiplatelet Medications in Adults Undergoing Percutaneous Interventions.

Objective: Many radiologists are unfamiliar with the new antithrombogenic medications and how to modify patient management before nonvascular percutaneous procedures performed in a radiology department. In this article, we review the indications for use, mechanism of action, pharmacokinetics, dosing, and recommendations for periprocedural management of patients using these medications.

Conclusion: To improve patient safety, radiologists involved in percutaneous procedures should have knowledge of the antithrombotics that will be encountered routinely in clinical practice.

Impact of liposomal bupivacaine administration on postoperative pain in patients undergoing total knee replacement.

Study Objective: To determine whether liposomal bupivacaine, a long-acting anesthetic indicated for single-dose wound infiltration to produce postoperative analgesia, has an impact on postoperative pain in patients undergoing total knee arthroplasties (TKAs).

Design: Single-center retrospective cohort study.

Setting: Large tertiary and quaternary care hospital.

Impact of intraoperative acetaminophen administration on postoperative opioid consumption in patients undergoing hip or knee replacement.

Background: Opioid utilization for acute pain has been associated with numerous adverse events, potentially resulting in longer inpatient stays and increased costs.

Objective: To examine the effect of intravenous (IV) acetaminophen administered intraoperatively on postoperative opioid consumption in adult subjects who underwent hip or knee replacement.

Methods: This retrospective cohort study evaluated postoperative opioid consumption in 176 randomly selected adult subjects who underwent hip or knee replacement at Duke University Hospital (DUH).