Critical Care Alert – January 1, 2009

January 1, 2009

• Growth of Intensive Care Unit Use and Costs

  Tracking the utilization of intensive care unit (ICU) resources is important in informing clinicians of patterns of use and costs of care, especially as the proportion of patients aged 65 and older increases and ICU resources remain limited.

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• Is It Time to Jump off the Intensive Insulin Therapy Bandwagon?

  Although the original study by Van den Berghe et al sparked interest in the use of intensive insulin therapy in the ICU, subsequent studies have cast doubt on the efficacy and safety of this practice.

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• Improving Palliative Care in the ICU

  This study reports on the results of a single-hospital study of a quality improvement intervention to improve palliative care in the ICU.

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• Having the Right Tool: A Highly Visible Angle Indicator Improved HOB Elevation

  The purpose of this study was to determine whether use of a simple, easy-to-view, color-coded device could increase adherence to head-of-bed (HOB) elevation guidelines. The device consisted of a piece of glossy printer paper cut into a triangle.

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• Special Feature: End-of-life Decision Making: An Evidence-based Approach

  When critical illness occurs, the primary goal is to assist patients to survive the acute threat to their lives. This goal is commonly achieved with 75%-90% of patients who are admitted to an intensive care unit (ICU) surviving to discharge.

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• Pharmacology Watch: JUPITER: C-reactive Protein a Marker for CV Events?

  In this issue: The JUPITER trial causes a stir; ACP practice guideline for antidepressant use; testosterone for low libido; continued shortage of Hib vaccine; FDA Actions.

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• Clinical Briefs in Primary Care supplement

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