instruction:
Given a passage with a context and an answer, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.
question:
Context: There are few studies of quality interventions to mitigate the risk of transfusion-associated circulatory overload (TACO). Our aim was to reduce TACO risk in patients admitted to internal medicine at our hospital, by addressing gaps in transfusion practice.', 'A 3-month baseline audit of red blood cell (RBC) transfusion orders was conducted. An intervention consisting of a transfusion order set and physician checklist was developed and implemented based on identified gaps, followed by a 3-month post-intervention audit. Compliance with appropriateness criteria for RBC transfusion was ascertained, along with documentation of transfusion rate, diuretic usage and consent.', 'A total of 97 transfusion orders from 68 inpatients and 95 orders from 62 inpatients were audited in the baseline and post-intervention groups, respectively. Compliance with appropriateness criteria was similar pre- and post-intervention (87 versus 85%, P = 081). Specification of transfusion rate improved (84 versus 98%, P < 001), and diuretics were appropriately ordered more frequently for patients with TACO risk factors (37 versus 64%, P < 001). Timing of diuretics shifted from between or post-transfusion to pre-transfusion (35 versus 86%, P < 001), without increases in hypokalemia or acute kidney injury. No case of TACO was observed during the study. Documentation of specific risks discussed during consent discussion improved (4 versus 23%, P < 001).
Answer: A checklist and order set are tools that can improve the quality of transfusion orders by increasing the judicious use of pre-transfusion diuretics and augmenting the specification of transfusion rate. These interventions could be adapted to electronic order formats to improve transfusion safety.
answer:
Do an order set and checklist improve physician transfusion ordering practices to mitigate the risk of transfusion-associated circulatory overload?

question:
Context: The aim of this study was to investigate the relationship between intraoperative vasopressin infusion and postoperative cardiac enzymes.', 'A prospective, double-blind, randomized, controlled study.', 'A single tertiary cardiac center.', 'One hundred consecutive patients undergoing cardiac surgery with or without cardiopulmonary bypass.', 'The study was approved by the Institutional Review Board, and patients provided informed consent to participate. Patients were randomized by computer into 2 equal groups: Vasopressin or control. The blinded study included vasopressin administered at a dose of 1.8 U/h or 1.8 mL/h of normal saline, along with catecholamines. The drug was administered continually during surgery while patients needed catecholamines. The intervention was discontinued upon admission to the intensive care unit when information regarding the true character of the drug was reported to the doctor in charge of patients in the intensive care unit by one of the investigators. Primary outcomes were CK-MB and troponin T levels measured at 0, 6, and 12 hours postoperatively.', 'Of the 100 patients, 8 were excluded; the remaining 92 were randomized to either the vasopressin (n = 47) or control (n = 45) group. There were no significant differences in demographic data between the groups. Postoperatively at 0, 6, and 12 hours, there were no differences in CK-MB (U/l) (37.5 57.9 v 32.0 21.5, 29.4 41.1 v 24.4 23.1, and 21.4 21.3 v. 21.8 32.4, respectively) and troponin T (752.4 638.2 v 762.7 557.1, 753.8 507.3 v 777.6 515.0, and 774.6 572.6 v 698.7 540.2, respectively) values.
Answer: Vasopressin infusion has been used to treat catecholamine-unresponsive shock. In this study, intraoperative vasopressin was used safely as a possible first-line drug for treating hypotension; however, it did not increase the levels of cardiac enzymes after cardiac surgery.
answer:
Does vasopressin raise cardiac enzymes following cardiac surgery : a randomized double-blind clinical trial?

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Context: Atrial fibrillation (AF) and chronic kidney disease (CKD) are closely related. The present study aimed to evaluate the association between estimated glomerular filtration rate (eGFR) and outcomes after cryoballoon catheter ablation for AF.', 'We included a total of 110 patients (64.010.1 years, 64% men) with paroxysmal AF who underwent second-generation cryoballoon catheter ablation in this study. Recurrence and change in renal function after ablation were assessed by stratification of eGFR sub-groups.', 'During a mean follow-up period of 9 months, 20 (18%) patients had AF recurrence after the first catheter ablation procedure. Multivariate Cox regression analysis showed that eGFR [hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.93-0.99, p=0.047], non-pulmonary vein (PV) ectopic beats at initial ablation (HR 2.92, 95% CI 1.03-8.27, p=0.043), and history of stroke (HR 7.47, 95% CI 2.30-24.2, p=0.001) were independent predictors of recurrence after the ablation. Among the CKD groups, recurrence was found in 7% (1/15), 12% (9/73), and 46% (10/22) of the eGFR 90mL/min/1.73m
Answer: Low eGFR at baseline was an independent predictor of recurrence after cryoballoon ablation for paroxysmal AF. The presence of non-PV ectopic beats was significantly increased in patients with impaired renal function, which might be associated with a poor outcome.
answer:
Is impaired renal function associated with recurrence after cryoballoon catheter ablation for paroxysmal atrial fibrillation : A potential effect of non-pulmonary vein foci?