Critical Care Alert – May 1, 2003

May 1, 2003

• Should We Use Nitric Oxide with High-Frequency Oscillatory Ventilation in ARDS?

  The objective of this study was to prospectively evaluate the oxygenation effect of inhaled nitric oxide (iNO) delivered during high-frequency oscillatory ventilation (HFOV) in patients with the acute respiratory distress syndrome (ARDS).

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• Should Critically Ill Patients Receive Erythropoietin?

  In this large, randomized trial, critically ill patients who received weekly doses of recombinant human erythropoietin had higher hemoglobin levels and required fewer transfusions than placebo-treated patients.

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• Special Feature: Heliox in Acute Severe Asthma

  Alvan Barach, who pioneered the clinical use of oxygen, was also the first investigator to treat acute asthma by having the patient breathe a mixture of helium and oxygen. In 4 adult asthmatics, Barach demonstrated a reduction in dyspnea after just a few breaths of the helium-oxygen mixture, now known as heliox.

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• Critical Care Plus: Doing More With Less: The Advantages of an ‘E-ICU’

  Nationally, its estimated that patients need the services of 30,000 intensivists. since only about 6,000 board-certified intensivists are available, theres a big gap to be filled, and one company offering online clinical services has started filling it.

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• Critical Care Plus: A La Carte Approach to Critical Care Works Well

  Nine years ago, muhlenberg regional medical Center in Plainfield, NJ, opened Progressive Care, an intermediate critical care floor to serve patients with diagnoses and conditions that qualify them for ICU care but who dont require the full, intensive nursing and monitoring that an ICU traditionally provides. The system has worked so well that the facility has added a second such flexible unit.

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• Clinical Briefs in Primary Care Supplement

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• Pharmacology Watch: Counterfeit Procrit Uncovered by FDA Surveillance

  In one of the more bizarre stories of the year, the FDA has uncovered files of counterfeit Procrit (epoetin alfaJohnson & Johnson) in routine surveillance. To make matters worse, the fake vials have been contaminated with bacteria and many contain no active ingredient.

  Read more about Pharmacology Watch: Counterfeit Procrit Uncovered by FDA Surveillance - Critical Care Alert – May 1, 2003