Probiotics and lung diseases: Forsythe P, CHEST 2011;139:901-908.
Pseudomonas pneumonia: Epidemiology, clinical diagnosis, source (Part 1) Fujitani S et al, CHEST 2011;139:909-919.
Sleep medicine, a 3,000-year history: Kirsch DB, CHEST 2011;139:939-946.
Status epilepticus, refractory, treatment of: Holtkamp M, Curr Opin Crit Care 2011;17:94-100.
Subarachnoid hemorrhage, critical care of: Wartenburg KE, Curr Opin Crit Care 2011;17:85-93.
Tako-tsubo cardiomyopathy, natural history of: Parodi G et al, CHEST 2011;139:887-892.
Venous thromboembolism, long term management of: Bauer K, JAMA 2011;305:1336-1345.
Viral community-acquired pneumonia: Ruuskanen O, Lancet 2011;377:1264-1275.
Serious Infections in Intensive Care Units: 100+ pages, 12 articles reflecting the state of the art on managing infections and antibotic usage in the ICU. Sem Resp Crit Care Med, April 2011. Review.
Workshop on molecular diagnostics for respiratory tract infections: Procalcitonin shows promise as a biomarker for differentiating bacterial from viral pneumonias, and to assess response to therapy. Rapid PCR for MRSA in sputum may become available after further development & testing. Molecular tests for S. pneumonia in respiratory secretions currently are uninterpretable in practice, due to [… read more]
Combating antimicrobial resistance; Policy recommendations to save lives: Clin Infect Dis 2011;52 (supplement 5). ** COMMENTARY by Brad Spellberg, MD **
Candida urinary tract infections: Clin Infect Dis 2011;52 (supplement 6).
Transtracheal oxygen therapy: Christopher KL, Schwartz MD
Long-term oxygen therapy: Christopher KL & Porte P, CHEST 2011;139:430-440
Long-term complications of critical care: Desai SV, Crit Care Med 2011;39:371-379.
Sadaka et al add their two cents and a cohort study to the Xigris efficacy/safety debate. In their retrospective, propensity-matched analysis of 563 patients sourced from the Project IMPACT database, the 108 who received activated protein C had 35% mortality, vs 54% for the 108 who did not (p=0.005). There were unusually low rates of [… read more]
Hooman et al pooled 5 randomized trials with 112 patients, who had 184 episodes of elevated intracranial pressure. They concluded hypertonic saline is better at reducing ICP; but the relative-risk-for-ICP-control confidence interval was 1.0-1.3 and the mean ICP reduction included zero (-1.6 to 5.7 mm Hg). So, maybe. Crit Care Med 2011;39:554-559.
Cochrane systematic review and meta-analysis: Pooling 11 randomized trials, n=1,971, Blackwood et al suggested there are some benefits to using a standardized weaning protocol. There was a reduction in weaning and ventilation time in the groups that had weaning protocols; we won’t report them here, because they would be misleading in this small space. They [… read more]
Drospirenone is the new progesterone analog in heavily marketed new oral contraceptive pills (trade names Yaz, Yasmin, Angelique). Using a large insurance claims database, Jick et al identified 186 cases of DVT or PE in women aged 15-44 taking oral contraceptives and compared them to controls. Those taking drospirenone-containing OCPs had a nonfatal DVT/PE incidence [… read more]
Autonomy and beneficence, a historical perspective. Will JF, CHEST 2011;139:669-673. ICU ethics review.