GI and Nutrition

Sep 302011
 

Hao et al pooled data from 10 heterogeneous randomized trials (n=3,451) comparing probiotics (various preparations) vs. placebo, with the outcome of upper respiratory tract infections. Those using probiotics had a reduction in number of URTIs and antibiotic prescriptions by ~1/3 to ~1/2. There was significant heterogeneity among the trials, which included very few people over [… read more]

Jun 262011
 

The best approach to nutrition during critical illness is unknown. Casaer et al randomized 4,640 critically-ill patients who could not get enough calories by enteral feeding to receive TPN either on ICU day 3, or to wait until ICU day 8. While waiting for their TPN in the late group, patients got calories in sugar [… read more]

Jun 122011
 

Pileggi et al analyzed 28 studies and concluded that decontaminating the GI/respiratory tract with antiseptics reduced ventilator-associated pneumonia by 27%; decontamination with antibiotics reduced VAP by 36%. Antibiotic decontamination also reduced ICU infections in general, by 29%. Critical Care 2011;15:R155. FREE FULL TEXT Also see last month’s “Oral / gastric antibiotic decontamination reduced bacteremias in [… read more]

May 072011
 

De Smet et al reheat the data from their 2009 NEJM study, in which they cluster-randomized and crossed-over 5,939 patients staying >48hrs in 13 Dutch ICUs to receive either 1) standard care; 2) selective oropharyngeal decontamination (topical amphotericin B, colistin, and tobramycin in the oropharynx), or 3) selective digestive tract decontamination (the same drugs in the mouth, stomach, [… read more]