Critical care medicine
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Critical care medicine · Jan 2013
Review Meta AnalysisThe role of ω-3 fatty acid supplemented parenteral nutrition in critical illness in adults: a systematic review and meta-analysis.
To determine whether the supplementation of parenteral nutrition with ω-3 fatty acids confers treatment benefits to critically ill adult patients. ⋯ On the basis of this systematic review, it can be concluded that ω-3 fatty acid supplementation of parenteral nutrition does not improve mortality, infectious complications, and intensive therapy unit length of stay in comparison with standard parenteral nutrition. Although ω-3 fatty acids appear to reduce hospital length of stay, the poor methodology of the included studies and the absence of other outcome improvements mean they cannot be presently recommended.
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Critical care medicine · Jan 2013
Multicenter Study Clinical TrialImplementation of clinical practice guidelines for ventilator-associated pneumonia: a multicenter prospective study.
Ventilator-associated pneumonia is an important cause of morbidity and mortality in critically ill patients. Evidence-based clinical practice guidelines for the prevention, diagnosis, and treatment of ventilator-associated pneumonia may improve outcomes, but optimal methods to ensure implementation of guidelines in the intensive care unit are unclear. Hence, we determined the effect of educational sessions augmented with reminders, and led by local opinion leaders, as strategies to implement evidence-based ventilator-associated pneumonia guidelines on guideline concordance and ventilator-associated pneumonia rates. ⋯ A 2-yr multifaceted intervention to enhance ventilator-associated pneumonia guideline uptake was associated with a significant increase in guideline concordance and a reduction in ventilator-associated pneumonia rates.