Critical Care Alert – November 1, 2003

November 1, 2003

• Safer Suctioning with Pressure Support

  In this study, the effect of endotracheal suctioning-induced alveolar derecruitment was studied. The study population consisted of 9 sedated and paralyzed patients with acute lung injury.

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• Bilateral Pleural Effusions: Do Both Sides Need to be Tapped?

  In this retrospective review of 33 patients with bilateral pleural effusions who had the fluid on both sides tapped, the cause of the effusions was most often cardiac disease and seemed to be the same on both sides in every case.

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• Are ‘Routine’ Daily Chest X-Rays Justifiable in ICU Patients?

  For patients who required > 48 hours of mechanical ventilation, daily routine chest radiographs and films obtained based on clinical indications produced similar outcomes.

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• Special Feature: Avoiding Adverse Events in the ICU

  Health care workers are expected to practice without error, an ideal that in reality does not occur. In fact, errors occur more frequently that we would prefer.1-3 Because the likelihood of adverse events tends to increase with the severity of illness and complexity of care, the risk for errors is especially high in critical care settings.

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• Critical Care Plus: Early, Aggressive ICU Nutrition Drawing More Advocates

  Most large hospitals today have dedicated icu nutritionists who make nutritional recommendations for every critically ill patient admitted.

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• Critical Care Plus: Who Gets What in Critical Care?

  Two severely ill patients in the emergency department of your hospital need admission to intensive care, but only one bed is available. Who gets admitted first?

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• Pharmacology Watch: Generic Paxil Scheduled to Hit Market this Fall

  A generic form of paroxetine (PaxilGlaxoSmithKline) will soon be on the market. The drug marks the second SSRI antidepressant to go generic after fluoxetine (Prozac) last year.

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