Society of Critical Care Medicine 2010 Critical Care Congress

New research presented at the Society of Critical Care Medicine, Critical Care Congress from January 9-13, 2010, in Miami Beach addressed key issues in critical care. The features highlight just some of the studies that emerged from the congress. NRT: Assessing Mortality in Critically Ill Smokers The Particulars: Nicotine replacement therapy (NRT) is often given to smokers admitted to the ICU to prevent withdrawal symptoms, but the safety of NRT in the critically ill has not been well studied. Data Breakdown: A study evaluated 330 active smokers, 174 of whom received NRT upon admission to the ICU. NRT was not associated with increased hospital mortality after adjusting for severity of disease, pack-years of smoking, and do-not-resuscitate status upon ICU admission (odds ratio, 1.6). About 23.0% of NRT patients experienced delirium compared with a 13.1% rate for non-NRT recipients. Take Home Pearls: NRT does not appear to be associated with increased hospital mortality in critically ill active smokers. However, NRT recipients appear to experience more delirium than the non-NRT group. The decision to use NRT in critically ill patients should be balanced individually between risks and benefits for patients. Fresh Blood Better for Transfusing Children in ICUs The Particulars: Transfusion with red blood cells (RBCs) is a common treatment in pediatric intensive care. Past studies conducted with adults have suggested that prolonged length of RBC unit storage is associated with worse clinical outcomes, but data are lacking in children. Data Breakdown: An analysis from a large observational study evaluated 447 children who stayed 48 hours or longer in a pediatric ICU. Results showed an adjusted odds ratio of 1.87 for...