Review Articles Archives - Page 10 of 15 - PulmCCM
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Review Articles Articles

Sep 082011
 

Part 1 of Levine et al’s excellent review on toxicology in the ICU. Some of their helpful recommendations/reminders: False positive UDS are common for tricyclics (diphenhydramine/Benadryl, carbamazepine, quetiapine/Seroquel), as are false negatives for benzodiazepines (lorazepam/Ativan, alprazolam/Xanax). The osmolal gap is elevated in ethanol, methanol, ethylene glycol, isopropanol, propylene glycol toxicity, but also in shock and [… read more]

Sep 032011
 

Everything new in COPD from the 10th Lund COPD Symposium, including biomarkers, risk factors, research into systemic effects and exacerbation prevention, and the latest cutting edge treatment: “Activity Promotion” (the article declares this a “paradigm shift” …. but wasn’t trying to get people to move more also part of the old paradigm?) Proc Am Thorac [… read more]

Sep 022011
 

September’s Current Opinion in Pulmonary Medicine has 4-5 review articles each on sarcoidosis (how to handle calcium problems; cardiac sarcoid); interstitial lung disease (biologics for connective-tissue disease related ILD; LAM therapies; stem cell therapy for pulmonary fibrosis), and pulmonary vascular disease. Curr Opin Pulm Med 2011;17.

Aug 242011
 

Muscedere J. Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis. Crit Care Med 2011;39:1985-1991. In short, it probably works to prevent ventilator-associated pneumonia (13 randomized trials, n=2,442. 12 were positive, pooled risk ratio 0.55, associated with 1-1.5 shorter days in the ICU and on the ventilator). So why not use [… read more]

Aug 232011
 

An excellent free full text review by Paul O’Byrne. What’s new here: Did you know that formoterol is used as a first-line rescue inhaler, outside the U.S.? Formoterol has a steeper dose-response curve than salmeterol: repeated doses have an additive bronchodilator effect. The use of budesonide/formoterol as a combination maintenance AND rescue inhaler (added prn [… read more]

Aug 212011
 

Schuetz et al review the 16 randomized controlled trials (n=4,647) testing procalcitonin-guided vs. standard care on the outcomes of antibiotic use, mortality, and infection control. Most of these studies were done in Europe; 6 were in ICU patients. Using procalcitonin reduced antibiotic use in all settings (primary care, emergency department, ICU) with no detectable differences [… read more]

Aug 142011
 

Accountability for Medical Error: Moving Beyond Blame to Advocacy. CHEST 2011;140:519-526.  Bell et al’s great essay on the dysfunctional mechanics and culture of liability / safety / blame surrounding medical errors in hospitals and our medical care system in general. They propose steps toward “collective accountability,” e.g., we MDs should sit on hospital safety committees. But [… read more]