 Aortic Valves Best Replaced at High-Volume Centers
High-risk patients undergoing aortic valve replacement (AVR) experience less morbidity and mortality at the hospitals that perform the most procedures, a population-based study reported.
Mortality at high volume hospitals was 2.41% versus 4.34% at low volume hospitals, wrote Himanshu J. Patel, MD, of the University of Michigan, and his co-authors, in the October 31 issue of Annals of Thoracic Surgery.
The "hinge point" that distinguished a high-volume center was 390 procedures over 4 years. FULL STORY»
IV Fluids: Don't Hold the Salt
Pediatric patients who received maintenance doses of hypotonic fluids intravenously were at increased risk for iatrogenic hyponatremia compared with those who received isotonic fluids, investigators reported here.
A systematic review of 10 randomized controlled trials showed there was an overall greater than two-fold risk of low plasma sodium among pediatric patients who received hypotonic fluids intravenously while hospitalized (RR 2.28, 95% CI 1.73-3.00), according to Byron Foster, MD, MPH, of the University of Texas Health Science Center at San Antonio, and colleagues.
Hypotonic fluid receipt was associated with a 6.1-fold risk of moderate hyponatremia versus receipt of isotonic fluids (95% CI 2.2-17.3), Foster said during an oral presentation at the meeting of the American Academy of Pediatrics.
FULL STORY»
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