Critical Care Alert – April 1, 2008

April 1, 2008

• Intensive Insulin Therapy and Colloid Resuscitation in Severe Sepsis

  This multicenter randomized trialnicknamed the VISEP studyused a two-by-two factorial design to test two independent treatments in severe sepsis patients.

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• Considering CORTICUS: Hydrocortisone in Septic Shock

  This multicenter, randomized, double-blind, placebo-controlled trial of hydrocortisone replacement in septic shock aimed to evaluate 28-day mortality in non-responders to corticotropin stimulation.

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• Ethanol or Benzodiazepines to Prevent Alcohol Withdrawal in the ICU?

  Trauma surgeons at the Regional Medical Center at Memphis carried out a randomized clinical trial comparing a continuous ethanol infusion with a protocol of scheduled diazepam administration for the prevention and control of severe alcohol withdrawal syndrome (AWS) among patients admitted to their ICU following trauma.

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• Special Feature: Do Higher PEEP and Lung Recruitment Improve Outcomes in ARDs?

  It is now well established that ventilating patients with acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) using a strategy that limits alveolar distending volume and end-inspiratory static airway pressure results in improved survival, as compared to larger-volume, higher-pressure ventilation.

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• Pharmacology Watch: Erythropoietin and Cancer Death Rates

  In this issue: Does erythropoietin worsen cancer death rates? Most hypothyroid patients can be replaced with levothyroxine alone without additional T3. Does aggressive control in type 2 diabetes save lives?

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• Clinical Briefs in Primary Care supplement

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