Critical Care Alert – December 1, 2012

December 1, 2012

• Doxycycline May Protect Against Clostridium Difficile Infection

  Doernberg and colleagues sought to determine whether receipt of doxycycline was associated with protection from development of Clostridium difficile infection (CDI) in hospitalized patients being treated with ceftriaxone, a known high-risk antibiotic for CDI.

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• Lie Still, Sleep Becalmed: The Effects of Deep Sedation in the First 48 Hours of ICU Care

  The authors note a paucity of literature on early (0-48 hours of ventilation and ICU admission) sedation practices and their impact on outcomes; thus they performed this multicenter prospective cohort study with the hypothesis that early sedation is associated with delirium, time to extubation, and hospital and 180-day mortality.

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• Psychological Distress Decreased When Families Completed Daily ICU Diary

  Family members of patients recovering from critical illness may experience psychological problems, including anxiety, depression, and post-traumatic stress disorder (PTSD). Jones and colleagues reasoned that provision of an ICU diary, written in everyday language by ICU staff, would be beneficial to family members by providing an explanation of daily events and opportunity for expression of feelings and contribution to the plan of care.

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• The Cuff-Leak Test for Predicting Post-Extubation Stridor: Are We Focusing on the Wrong Question?

  The cuff-leak test (CLT) was performed prospectively in this study using the volume technique whereby the difference between inspired and expired tidal volume before and after cuff deflation is used to detect the presence of laryngeal edema and the likelihood of developing post-extubation stridor.

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• Can We Predict Long-Term Cognitive Impairment in Survivors of Critical Illness?

  As more patients are surviving critical illness, there is documentation of serious cognitive, physical, and psychiatric consequences arising from lengthy ICU stays in these patients.

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• Pharmacology Watch: Menopausal Hormone Therapy and the Risk for VTE, AD

  In this issue: Dementia and benzodiazepines; effectiveness of omega-3 fatty acid and Ginkgo biloba supplements; and FDA actions.

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• Clinical Briefs in Primary Care supplement

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