Critical Care Alert – November 1, 2009

November 1, 2009

• Does ECMO Save Lives in Severe ARDS?

  Peek and colleagues have recently published the long-awaited and much-discussed results of the CESAR trial (Conventional ventilatory support vs Extracorporeal membrane oxygenation [ECMO] for Severe Adult Respiratory failure), a British study that has been underway for nearly a decade.

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• Does the Risk Associated With Hyperglycemia Occur Across All Patient Groups?

  After initial trials showed a mortality benefit from the use of insulin drips and tight glucose control in the ICU, subsequent studies have shown mixed results and, in some cases, increased mortality and episodes of hypoglycemia.

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• No Method Is Perfect for Detecting Delirium In ICU Patients, but Some Methods Are Better Than Others

  Delirium is a common and serious disorder in ICU patients, with up to 87% incidence in some ICU populations. Studies have shown that delirium is associated with higher costs and complication rates, namely increased ventilator days and longer hospital stays.

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• Pharmacology Watch: SSRIs and Pregnancy: Increase in Septal Heart Defects

  In this issue: Depression and pregnancy, new vaccine recommendations from the CDC, cortico-steroids and/or antivirals for Bell's palsy, rasagiline and Parkinson's disease, and FDA Actions.

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• Clinical Briefs in Primary Care supplement

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