In this before-after study of ventilated patients, an oral care protocol (q4 hours) reduced the incidence of ventilator-associated pneumonia from 12.6 to 1.3 cases / 1000 ventilator days. This adds to the literature that evidence-based protocols can improve quality (abstract).
My patient was a 69 year old lady with metastatic small cell lung cancer. She was on experimental chemotherapy and was admitted from clinic with worsening lower extremity edema and a new oxygen requirement. She underwent a chest and abdominal CT that revealed new pulmonary masses, tumor and a mass invading her right pulmonary artery, […]
The large multi-center ICU trial randomized ICUs to 1 of 3 strategies: MRSA screening/isolation, MRSA screening/isolation/decolonization, or global decolonization (5 days BID nasal mupiricin and daily chlorhexidine bathing). The hazard ratios for MRSA isolates in the 3 groups were 0.92, 0.75, 0.63 respectively. The hazard ratios for any bloodstream infection in the 3 groups were […]
This trial found no difference in patient outcomes (mortality or LOS) if admitted during a time of 24/7 intensivist coverage, or during a time with only daytime intensivist coverage (with home call at night) in a medical ICU. This study does not show a patient benefit to a 24/7 intensivist staffing model in an academic […]