Critical Care Alert – October 1, 2006

October 1, 2006

• Enhancing Patient Safety During Hand-Offs

  Transfers of care can be problematic if critical information is not shared when responsibility transitions between clinicians. Although such "hand-offs" create the opportunity for error, transfer management in United States hospitals has never been described on a national level.

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• Oral Decontamination and Ventilator-Associated Pneumonia

  In this randomized-controlled trial, Koeman and associates wanted to determine the effect of two oral decontaminating gels, chlorhexidine 2% (CHX) or chlorhexidine 2% plus colistin 2% (CHX/COL), compared to a placebo, on the development of ventilator-associated pneumonia (VAP) in patients requiring more than 48 hours of mechanical ventilation.

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• Are We Following the New Guidelines for Ventilator-Associated Pneumonia?

  In this prospective observational study, Kollef and associates enrolled patients with ventilator-associated pneumonia (VAP) in 20 ICUs across the United States in order to characterize the patients and the antimicrobial regimens used in treating them, as well as their mortality and lengths of stay.

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• Special Feature: Life After ARDS: What Survivors Tell Us

  In the early 2000s, substantial evidenced-based interventions were added to the care of critically ill patients that significantly reduced mortalityincluding low tidal volume ventilatory support for acute respiratory distress syndrome (ARDS), protocolized sedation with daily awakening, Drotrecogin-alpha for severe sepsis, tight glycemic control, corticosteroids for refractory septic shock and preventative strategies for ventilator associated pneumonia.

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• Pharmacology Watch: The Indictment of Pharma Industry Marketing Practices

  TNF Blockers: Should You Be Concerned?; FDA Actions

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• Clinical Briefs in Primary Care supplement

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