
Recommend taking at least one antihypertensive medication at night. This simple, cost-effective intervention was recently shown in the MAPEC trial to modestly reduce cardiovascular events and mortality.

Recommend taking at least one antihypertensive medication at night. This simple, cost-effective intervention was recently shown in the MAPEC trial to modestly reduce cardiovascular events and mortality.

As it turns out, patients with ARDS should be belly sleepers. The PROSEVA trial, freshly published in NEJM, examined the role of prone positioning in patients with early, severe acute respiratory distress syndrome (ARDS).

Voluven (hydroxyethyl starch 130/0.4) was heralded to the hospital community as a cheaper alternative to albumin, but safer than previous hydroxyethyl starch (HES) products that were shown to cause bleeding and renal failure.
Although Voluven is likely “safer” than older HES products, it still is NOT safer than traditional volume repletion with normal saline or albumin. It was a good run, Voluven, but it’s time to pull the plug.

The ASPIRE trial, recently published in the NEJM, examined the role of aspirin after patients with VTE’s had completed at least 6 weeks of full anticoagulation (although most completed 6+ months). This is the sister trial to the WARFASA trial, which required 6-18 months of warfarin therapy.

The WARFASA trial, recently published in the NEJM, examined the role of aspirin after patients with VTE’s had completed 6-18 months of warfarin therapy. Given the safety of the treatment and the impressive reduction in VTE recurrence, it’s very likely that the results of the WARFASA trial will find their way into the next CHEST guideline updates. Continue reading