tailieunhanh - Báo cáo khoa học: "Recently published papers: choose well, treat well, get well – which matters most"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Recently published papers: choose well, treat well, get well – which matters most? | Available online http content 8 2 91 Commentary Recently published papers choose well treat well get well -which matters most Justin Kirk-Bayley1 and Richard Venn2 Specialist Registrar Anaesthesia and Intensive Care Frimley Park Hospital Surrey UK 2Consultant Anaesthesia and Intensive Care Worthing Hospital West Sussex UK Correspondence Justin Kirk-Bayley jkb@ Published online 1 March 2004 Critical Care 2004 8 91-92 DOI cc2839 This article is online at http content 8 2 91 2004 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Choice underpins everything we do as critical care clinicians. We choose whether to treat when to treat and how to treat from an ever-increasing selection of alternatives and whether to afford the costs associated with the decisions we have made. Some recent articles have looked at how one chooses to ventilate patients noninvasively or not how to deal with and avoid ventilator-acquired pneumonia and which regimens of antibiotics to use and how it affects outcome. It is these articles on which we shall focus. Choose well Choosing the antibiotic to use in early sepsis is influenced by many things likely causative organisms for the source found if any local variations of pathogens and known patterns of resistance. Logically then targeting sepsis with the correct initial antibiotic choice should influence overall patient outcome. But does it Garnacho-Montero and colleagues looked at how adequate empirical antibiotic choice affected outcome and the mortality rate in 400 patients on admission to the intensive care unit ICU 1 . Adequate meant at least one effective drug two drugs for Pseudomonas infection as judged by antimicrobial susceptibility included in the empirical antibiotic treatment. Garnacho-Montero and colleagues found that inhospital mortality was eight times more probable in patients receiving inadequate antimicrobial therapy in the first 24 hours and that adequate therapy reduced .