Critical Care Alert – March 1, 2006

March 1, 2006

• Intensive Insulin Therapy in the Medical ICU

  In a previous study involving patients in a surgical ICU1, Van den Berghe and associates at the Catholic University of Leuven, Belgium, showed that tight control of serum glucose levels by means of a strict insulin infusion protocol decreased both morbidity and mortality.

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• Intensivist-to-Bed Ratio Impacts Length-of-Stay in the Medical ICU

  This study examined the effect of variations in ICU staffing, defined in terms of intensivist-to-ICU bed ratio, on ICU length-of-stay (LOS) and ICU and hospital mortality. The study was conducted at the Mayo Clinic in Rochester, MN over a 9-month period when the medical ICU underwent a series of planned changes which resulted in its capacity increasing from 15 to 24 beds.

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• Patients’ Recollections of Therapeutic Paralysis in the ICU

  Ballard and colleagues conducted this qualitative study to obtain recollections of critically ill patients who were given neuromuscular blocking agents (NMBAs) (for a minimum of 6 hours) and sedatives and/or analgesics.

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• Special Feature: Care Bundles in the ICU

  The Institute of Medicine has documented that the hospitaland the ICU in particularis an environment in which errors are all too frequent.

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• Clinical Briefs in Primary Care supplement

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• Pharmacology Watch: Treating Opioid-Dependent Patients with OAT

  Long-Term Effects of Warfarin Use; Statins Multiple Benefits; FDA Actions

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