Cognitive Effects of Estrogen Therapy; Vitamin Therapy and Restenosis; Echinacea and the Common Cold; Effects of Paxil in Children Under 18; FDA Actions.
Ventilator-associated pneumonia (vap) is nosocomial pneumonia occurring in a mechanically ventilated patient > 48 hours after intubation. It is categorized as early-onset (defined by most experts as 48-96 hours after intubation) and late-onset (> 2-96 hours after intubation): these differ with respect to responsible bacterial agents as well as outcomes. With an estimated incidence of 8-28% of intensive care unit (ICU) patients, or 13-35 cases per 1000 ventilator-days, VAP is common.
This meta-analysis of clinical trials of steroids in septic shock demonstrates that whereas short-term, high-dose administration actually worsens survival, giving lower doses for a longer period hastens shock resolution and improves survival.
This issue reviews the current status of SARS, influenza, and community-acquired pneumonia, providing essential information for emergency physicians and recommendations at a time when the therapeutic landscape for management of patients constantly is evolving.
