Critical Care Alert 2004-01-01

Shorter Antibiotic Course Effective in Ventilator-Associated Pneumonia

Ventilator-associated pneumonia (VAP) remains a difficult problem in critically ill patients, both in diagnosis and treatment.

Pulmonary Artery Catheters Unhelpful in Shock and ARDS

In this randomized, multicenter trial, early use of a pulmonary artery catheter in patients with shock, ARDS, or both did not significantly alter mortality or morbidity.

ICU Delirium Common in Older Patients

Among patients aged 65 or older, 31% were delirious on admission to the ICU, and 70% experienced delirium at some time during their hospitalization.

Preventing Contrast Nephropathy

Meta-analysis of published clinical trials showed that a regimen of oral acetylcysteine administration along with hydration reduced the relative risk of developing contrast nephropathy by 56% among patients with pre-existing renal insufficiency.

Dedicated Medication Nurse Did Not Reduce Error Rates

Use of a dedicated medication nurse had no effect on the total number of medication errors based on observations performed in medical, surgical, and mixed medical-surgical units.

Special Feature: Recruitment Maneuvers in ARDS

Mechanical ventilation (MV) is a supportive life-saving therapy in patients with acute respiratory distress syndrome (ARDS). In the last decade, the possibility that MV can produce alterations in lungs, namely ventilator-induced lung injury, has been recognized.

Clinical Briefs in Primary Care Supplement

Pharmacology Watch: Vioxx Might Control Postoperative Knee Pain

Oral rofecoxib (Vioxx) may have a role in controlling postoperative pain patients undergoing knee surgery.

Critical Care Alert – January 1, 2004

January 1, 2004