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Administration of intravenous fluids without prior assessment of fluid response based on dynamic testing is not recommended during circulatory failure.
Smarter medicine
Sociedad Suiza de Medicina Intensiva
The expected positive effects are a reduction in the administration of intravenous fluids and associated costs and a reduction in associated complications (fluid overload, renal failure, metabolic complications). The evidence supporting the measure is observational studies, expert advice and best practices, and recommendations from professional societies.
ver más ... 2021It is not recommended to administer parenteral nutrition in the first 4 to 6 days of intensive care stay in a patient without nutritional deficit.
Smarter medicine
Sociedad Suiza de Medicina Intensiva
The expected positive effects are a reduction in parenteral nutrition and associated costs and a reduction in associated complications (infections, liver or metabolic complications). The evidence supporting the measure is intervention studies and recommendations from professional societies.
ver más ... 2021Routine or periodic complementary examinations are not recommended if they are not performed for the purpose of answering a specific clinical question relevant to the patient.
Smarter medicine
Sociedad Suiza de Medicina Intensiva
The expected positive effects are a reduction in the general consumption of examinations and associated costs, a reduction in the negative consequences (irradiation, anemia) and a reduction in the risk of unnecessary or unsuitable treatments. The evidence that shows the medida its intervention studies, observational studies, metanálisis and recommendations of professional societies.
ver más ... 2021Repeat colonoscopy is not recommended for at least 5 years in patients with one or two small adenomatous lesions (<1 centimeter), without high-grade dysplasia, completely removed by total colonoscopy.
Smarter medicine
La Sociedad Suiza de Gastroenterología
The date of a follow-up colonoscopy should be determined based on the results of a prior total colonoscopy. There are (published) evidence-based recommendations that patients with one or their small tubular adenomas with low-grade dysplasia should be monitored by follow-up colonoscopy within five to ten years after the initial polypectomy. The specific date within this range should be based on other clinical factors, such as previous colonoscopy results, family history and patient preferences, ...
ver más ... 2021It is not recommended to administer broad-spectrum antibiotics without an initial assessment of the adequacy of treatment and with daily assessment of the possibility of de-escalation.
Smarter medicine
Sociedad Suiza de Medicina Intensiva
The expected positive effects are a decrease in the overall consumption of broad-spectrum antibiotics, a reduction in associated complications (allergies, kidney failure, liver failure, secondary infections with resistant germs) and a decrease in selection pressure and resistance development.
ver más ... 2021