Effect of Tiered Implementation of Clinical Decision Support System for Acute Kidney Injury and Nephrotoxin Exposure in Cardiac Surgery Patients.

Background:  Nephrotoxin exposure may worsen kidney injury and impair kidney recovery if continued in patients with acute kidney injury (AKI).

Objectives:  This study aimed to determine if tiered implementation of a clinical decision support system (CDSS) would reduce nephrotoxin use in cardiac surgery patients with AKI.

Methods:  We assessed patients admitted to the cardiac surgery intensive care unit at a tertiary care center from January 2020 to December 2021, and August 2022 to September 2023.

β-Lactams plus doxycycline versus azithromycin for treatment of severe community-acquired pneumonia in critically ill patients.

Objectives: Community-acquired pneumonia (CAP) is a significant source of hospital admissions and mortality. Atypical organisms are implicated in up to 40% of cases of CAP diagnoses. We studied the difference in outcomes of severe CAP patients treated with doxycycline versus azithromycin in addition to β-lactam therapy.

Tocilizumab Versus Baricitinib for the Treatment of COVID-19 in Patients With Obesity.

Tocilizumab and baricitinib have emerged as potential treatments for patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) following the findings of the Recovery Group and the results of the COV-BARRIER study. Unfortunately, there is a lack of guidance regarding the use of these agents in high-risk patients, such as those with obesity. To compare the outcomes of tocilizumab and baricitinib as potential treatments for obese patients infected with SARS-CoV-2.

Duration of Gram-negative antibiotic therapy in patients with pneumonia prior to and after the implementation of MRSA nasal swabs, an antimicrobial stewardship tool.

Background: The implementation of MRSA PCR nasal swabs has been shown to decrease the use of anti-MRSA therapies through faster antibiotic de-escalation in patients with pneumonia. While this benefit has been shown exclusively in Gram-positive therapy, swab results may lead to additional antibiotic de-escalation discussions early on, potentially providing reduced durations or de-escalations of Gram-negative therapy as well.

Objectives: To determine if early de-escalation discussions prompted by MRSA swab results lead to shorter durations of Gram-negative antibiotic therapy.

A Review of Push-Dose Vasopressors in the Peri-operative and Critical Care Setting.

During hospitalization, the risk of hypotension and associated sequelae remain important considerations for patient outcomes. The use of push-dose vasopressors (PDP) outside of the operating room has increased in recent years to combat the negative effects of hypotension. This narrative review evaluates the utility of PDP in its traditional perioperative setting as well as in areas of increasing use such as the emergency department and intensive care unit.