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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

My Heart is Racing! Select Cardiac Arrhythmias and Practice Updates

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miércoles, 20 de febrero de 2013

Cirrosis


Treating Cirrhotics: What's the NNT?
by  David H. Newman, MD 
on February 18, 2013
"A series about the cold, hard numbers behind some of our most common ED practices
edited by David H. Newman, MD
{Antibiotics}
Q: Does it help to use prophylactic antibiotics during management of gastrointestinal bleeding in cirrhotic patients?
a: Yes!
by Daniel P. Runde, MD
NNT=4
For every 4 pts treated with antibiotics, 1 infection is prevented; for every 22 pts treated, 1 death is prevented
NNH=?
Side effects were not well tracked in these studies, but were probably less common than benefits
Color Code:
Green: More benefit than harm
Take Home Message: Antibiotics for cirrhotics with upper GI bleeding appear to save lives by reducing infections.
*
{Octreotide}
Q: Do somatostatin analogues drugs improve survival or reduce morbidity during acute variceal bleeding?
a: NO!
by Lucy Willis, MD
NNT
There was
NO BENEFIT
NNH
No serious medical harms were identified

Color code: Red: Intervention proven to be of no benefit
Take Home Message: Somatostatin analogues like octreotide did not reduce morbidity or mortality in randomized trials of patients with variceal bleeding"