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Society of Critical Care Medicine’s 2012 Annual Congress

New research was presented at the 2012 Society of Critical Care Medicine’s Critical Care Congress from February 4-8 in Houston. The features below highlight just some of the studies that emerged from the conference. >> Analyzing Short-Course Antibiotic Use for VAP >> Caloric Restrictions & Acute Lung Injury >> Assessing VTE Prophylaxis After Intracranial Hemorrhage Analyzing Short-Course Antibiotic Use for VAP The Particulars: Antibiotic treatment for ventilator-associated pneumonia (VAP) caused by organisms other than non–lactose-fermenting Gram-negative bacilli (NLFGNB) is typically stopped after 8 days. Data suggest that infections persist at Day 8 when VAP is caused by NLF-GNB. It is unknown if an 8-day course of antibiotics for NLF-GNB infection would be adequate or result in persistent primary infection. Data Breakdown: A retrospective review of 77 patients with VAP showed that persistent primary infection was present in 60% of patients with NLF-GNB infection after 8 days of antimicrobial therapy. Among those with NLF-GNB, only 56% of pathogens obtained on repeat bronchoalveolar lavage remained sensitive to the antimicrobial therapy. Take Home Pearls: An 8-day course of antimicrobial therapy for VAP caused by NLF-GNB infection appears to be insufficient. Study results suggest this course of treatment may result in persistent primary infection.  Caloric Restrictions & Acute Lung Injury The Particulars: Mechanically ventilated patients are generally provided some form of artificial nutrition, but the optimal nutritional strategy in critically ill patients is undetermined. Some studies suggest better outcomes with initial full enteral feeding, while others indicate that hypocaloric feeding improves short-term outcomes. Data Breakdown: A study of mechanically ventilated patients randomized participants to receive trophic feeding (400 kcal/ day) or full enteral...

Society of Critical Care Medicine’s 2012 Annual Congress

New research was presented at the 2012 Society of Critical Care Medicine’s Critical Care Congress from February 4-8 in Houston. The features below highlight just some of the studies that emerged from the conference.   » Analyzing Short-Course Antibiotic Use for VAP » Caloric Restrictions & Acute Lung Injury » Assessing VTE Prophylaxis After Intracranial Hemorrhage Analyzing Short-Course Antibiotic Use for VAP The Particulars: Antibiotic treatment for ventilator-associated pneumonia (VAP) caused by organisms other than non–lactose-fermenting Gram-negative bacilli (NLFGNB) is typically stopped after 8 days. Data suggest that infections persist at Day 8 when VAP is caused by NLF-GNB. It is unknown if an 8-day course of antibiotics for NLF-GNB infection would be adequate or result in persistent primary infection. Data Breakdown: A retrospective review of 77 patients with VAP showed that persistent primary infection was present in 60% of patients with NLF-GNB infection after 8 days of antimicrobial therapy. Among those with NLF-GNB, only 56% of pathogens obtained on repeat bronchoalveolar lavage remained sensitive to the antimicrobial therapy. Take Home Pearls:An 8-day course of antimicrobial therapy for VAP caused by NLF-GNB infection appears to be insufficient. Study results suggest this course of treatment may result in persistent primary infection. Caloric Restrictions & Acute Lung Injury [back to top] The Particulars: Mechanically ventilated patients are generally provided some form of artificial nutrition, but the optimal nutritional strategy in critically ill patients is undetermined. Some studies suggest better outcomes with initial full enteral feeding, while others indicate that hypocaloric feeding improves short-term outcomes. Data Breakdown: A study of mechanically ventilated patients randomized participants to receive trophic feeding (400 kcal/day) or...
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