Critical Care Alert – March 1, 2007

March 1, 2007

• Dealing with ICU Delirium

  Ouimet and colleagues at Maisonneuve-Rosemont Hospital in Montreal studied 820 consecutive patients admitted to their mixed medical-surgical ICU to determine the incidence of delirium, factors associated with it, and its clinical consequences. The patients were adults who stayed in the ICU more than 24 hours and survived for at least 1 day.

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• Diagnosing VAP: Less is More

  Ventilator-Associated Pneumonia (VAP) is a major nosocomial infection associated with increased morbidity and perhaps with some attributable mortality. There has been great controversy as to which is the best practical strategy to diagnose and treat VAP.

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• Prevalence of Burnout Among Intensivists is High

  Professional burnout is a psychological syndrome in response to chronic interpersonal stressors on the job. In order to determine the prevalence of burnout among physicians working in ICUs, and to investigate associated factors, the investigators carried out a nationwide one-day survey study in the adult ICUs of 189 French public hospitals.

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• Special Feature: Patient-Ventilator Dys-Synchrony During Lung Protective Ventilation

  In 2000, the Acute Respiratory Distress Syndrome Network (ARDSnet) reported an unprecedented low mortality for ARDS patients ventilated with a tidal volume of 6 mL/kg of predicted body weight (and a plateau pressure ¡Ü30 cm H2O) compared to a tidal volume of 12 mL/kg.

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• Pharmacology Watch: Higher HDL Cholesterol in Statin Therapy, Key to Slowing Atherosclerosis?

  Citalopram Useful for Depression in CDA Patients;; When to Stop Anticoagulation Before Surgery?;; Drug Warnings: Ranibizumab and Bevacizumab;; Growth Hormone Treatment, More Harm Than Good;; FDA Actions

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• Clinical Briefs in Primary Care supplement

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