Critical Care Alert – June 1, 2009

June 1, 2009

• Influenza in the ICU: Underuse of Personal Protective Equipment by Health Care Workers

  Along with yearly vaccination, the U.S. Centers for Disease Control and Prevention (CDC) recommend the use of personal protective equipment (PPE) by health care workers (HCWs) to prevent influenza infection in the ICU.

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• Intensive Insulin Therapy: A Bit More Sugar May Be Nicer

  This study was designed to determine whether intensive glucose control in ICU patients reduces mortality at 90 days. Secondary outcomes included survival time during the 90 days, cause-specific death, duration of mechanical ventilation, need for renal replacement therapy, and hospital and ICU lengths of stay.

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• Editor's Comment: Has Tight Glucose Control Come Full Circle?

  Intensive insulin therapy in the ICU is a dynamic and controversial issue that has played out in the medical literature, at the bedside, and in the offices of policy makers over the last 8 years.

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• What Should We Make of Candida Isolated from Respiratory Tract Samples?

  Colonization of the respiratory tract and other sites with Candida species is common in ICU patients but it is unclear how often these species cause pneumonia that warrants antifungal therapy.

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• Patients' Bath Basins May Serve as a Reservoir for Potential Sources of Infection

  This study examined patients' bath basins as a possible reservoir for bacterial colonization and a risk factor for subsequent hospital-acquired infections.

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• Distress Contagion: Interpreting Health Care Team Response to ICU Stressors

  The ICU is commonly viewed as a stressful environment. While common, stress responses are likely to vary over time, between individuals, and as a result of the context in which they occur.

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• Pharmacology Watch: Guidance on the Appropriate Use of NSAIDs

  In this issue: NSAIDs in the elderly; managing GI and CVD risk with NSAIDs; low-dose naltrexone and fibromyalgia; treating glucocorticoid-induced bone loss; FDA Actions.

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• Clinical Briefs in Primary Care supplement

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