Friday, May 28, 2010

Selective Digestive Decontamination decreases MODS

About 10 years ago we were doing SDD on all our ventilated patients, but we stopped because of a lack of good evidence of efficacy and the fear of developing bacterial resistance. A new Critical Care Medicine systematic review shows that SDD decreases MODS but not mortality.

It's not enough to change our practice, but it's still interesting nonetheless how the same stuff keeps coming up.

Wednesday, May 19, 2010

Proton pump inhibitors increase the risk of clostridial infection

Patients who were treated with PPI while being treated for clostridial infection had a 42% increased risk of recurrence
http://archinte.ama-assn.org/cgi/content/full/170/9/772

Monday, May 17, 2010

High dose intravenous magnesium drip may help patients with aneurysmal SAH

There was a significant decrease in delayed ischemic infarction in the group that was treated with a high dose magnesium drip to keep the serum magnesium level between 2 and 2.5. There was no statistically significant difference in mortality or GCS, although there was a suggestion to that effect. The morbidity of giving magnesium was nil, and it may help.