Critical Care Alert – February 1, 2011

February 1, 2011

• Electronic Surveillance of Ventilator Settings and Airway Pressures Can Increase the Use of Lung-Protective Ventilation

  In this study from the Mayo Clinic in Rochester, MN, Herasevich et al tested an electronic algorithm that incorporated patient characteristics and ventilator data and notified clinicians immediately when potentially injurious ventilator settings were being used.

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• Is It Safe to Use Etomidate When Intubating Patients With Sepsis or Septic Shock?

  Due to its lack of cardiovascular side effects, the short-acting non-barbiturate sedative, etomidate, has been one of the primary agents used to sedate hypotensive patients during rapid-sequence intubation (RSI).

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• Can Nebulized Heparin Reduce Ventilator-Induced Lung Injury?

  Laboratory studies and clinical data support the concept that prolonged mechanical ventilation (PMV) can induce or worsen lung injury, via activation of inflammatory mediators and/or microvascular fibrin deposition, processes that may be ameliorated by heparin.

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• Abstract & Commentary: Can We Use Serum Sodium Levels to Prognosticate in Patients with Pulmonary Embolism?

  Hyponatremia is frequently seen in patients with left ventricular failure and has recently been shown to be associated with right ventricular dysfunction and worse outcomes in patients with pulmonary hypertension.

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• Pharmacology Watch: Statin Use in Patients with Abnormal Liver Function

  In this issue: Statins and liver function; dosing timing for thyroxine; rivaroxaban for VTE, DVT, and stroke; echinacea and the common cold; and FDA actions.

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• Clinical Briefs in Primary Care supplement

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