Other bulletins in this series include:

Breast Surgery

Tuesday 13 May 2008

Iatrogenic delirium and coma: a "near miss".

Dunn WF, Adams SC, Adams RW.
200 First St SW, Mayo Foundation, Rochester, MN 55905. dunn.william@mayo.edu.

A 66-year-old woman was cared for at two referral institutions following a witnessed cardiac arrest in a local emergency department. Despite aggressive initial care, she failed to regain consciousness during a 28-day course. Based on an erroneous neurologic diagnosis of anoxic encephalopathy, pessimism regarding likelihood of improvement existed, prompting clinical consideration of withdrawal of care. The correct diagnosis of iatrogenic drug-induced coma alternating with drug-induced delirium only became apparent after the IV administration of repeated doses of a benzodiazepine antagonist. The patient and husband (co-authors) provide insights often unheard within care circles.

Sleep articles

Complaints about sleep in trauma patients in an emergency department in respect to alcohol use
Author(s): Tim Neumann
ISSUE: 2008 ; VOL 43 ; PART 3 (2008--January)
Journal Title: Alcohol and Alcoholism From Free Medical Journals . com (/1998 - /Embargo: 2 years)

From Proquest NHS (01/1999 - 03/2007)
Page: 305 - 313
Search the Web: [article] [author(s)]

Association of Sleep - Disordered Breathing With Postoperative Complications
Author(s): Dennis Hwang
ISSUE: 2008 ; VOL 133 ; PART 5 (2008-May)
Journal Title: Chest ( Formerly : Diseases of the Chest ) From Free Medical Journals . com (/1995 - /Embargo: 1 year) Customer Notes: 1997 v111/1 - Print Location: Macclesfield

From Proquest NHS (01/1997 - 11/2006)
Page: 1128 - 1134
Search the Web: [article] [author(s)]


Assessment of hypnotic effects and patient satisfaction in empirical use of sleep medicines
Author(s): Yamashiro , T . ; Homma , M . ; Kohda , Y .
ISSUE: 2008 ; VOL 33 ; PART 3 (June 2008)
Journal Title: Journal of Clinical Pharmacy and Therapeutics From EBSCO ( CINAHL with Full Text ) - via Athens (02/1998 - /Embargo: 12 months)
Page: 273-278
Search the Web: [article] [author(s)]

Update in Critical Care 2007

Author(s): Fowler , R . A . ; Adhikari , N . K . J . ; Scales , D . C . ; Lee , W . L . ; Rubenfeld , G . D .
ISSUE: 2008 ; VOL 177 ; PART 8
Journal Title: American Journal of Respiratory and Critical Care Medicine From Free Medical Journals . com (/1997 - /Embargo: 1 year)

From Proquest NHS (02/2003 - /)
Page: 808-819
Search the Web: [article] [author(s)]


Health Care - Associated Pneumonia ( HCAP ) : A Critical Appraisal to Improve Identification , Management , and Outcomes Proceedings of the HCAP Summit
Author(s): Kollef , M . H .
ISSUE: 2008 ; VOL 46 ; SUPP / 4
Journal Title: Clinical Infectious Diseases From Free Medical Journals . com (/1997 - /Embargo: 1 year)

From Proquest NHS (12/2004 - 07/2006)
Page: ALL
Search the Web: [article] [author(s)]

Infection Control and Hospital Epidemiology

May 2008, Volume 29, Issue 5

398–403
Factors Associated With Acquisition of Vancomycin-Resistant Enterococci (VRE) in Roommate Contacts of Patients Colonized or Infected with VRE in a Tertiary Care Hospital
Qian Zhou, MD, MHSc; Christine Moore, ART; Sarah Eden, RN; Agnes Tong, MSc; Allison McGeer, MD, FRCPC

404–409
Risk of Vancomycin-Resistant Enterococcus (VRE) Bloodstream Infection Among Patients Colonized With VRE
Chamion N. Olivier, MD, MSc; Ruth K. Blake, MT; Lisa L. Steed, PhD; Cassandra D. Salgado, MD, MS

410–417
Cross-Transmission of Multidrug-Resistant Acinetobacter baumannii Clonal Strains Causing Episodes of Sepsis in a Trauma Intensive Care Unit
Antonios Markogiannakis, MPH; George Fildisis, MD; Sofia Tsiplakou, MD; Alexandros Ikonomidis, PhD; Alexandra Koutsoukou, MD; Spyros Pournaras, MD; Evangelos N. Manolis, MD; George Baltopoulos, MD; Athanassios Tsakris, MD


454–456
Incidence of Methicillin-Resistant Staphylococcus aureus Nosocomial Infections in Intensive Care Units in Lyon University Hospitals, France, 2003–2006
M. Moalla, PharmD; D. Baratin, MD; M. Giard, MD; P. Vanhems, MD, PhD


475
Prevalence of Nosocomial Infections in Adult Intensive Care Units at a Kosova Teaching Hospital
Gazmend Spahija, MD; Lul Raka, MD; Gjyle Mulliqi, MD, PhD; Nexhmije Spahija, MD; Zana Bukoshi, MD; Faton Hoxha, MD, PhD; Avdyl Krasniqi, MD, PhD

Ventilator articles:

Effect of Clarithromycin in Patients with Sepsis and Ventilator - Associated Pneumonia
Author(s): Giamarellos - Bourboulis , E . J . ; Pechere , J . - C . ; Routsi , C . ; Plachouras , D . ; Kollias , S . ; Raftogiannis , M . ; Zervakis , D . ; Baziaka , F . ; Koronaios , A . ; Antonopoulou , A .
ISSUE: 2008 ; VOL 46 ; PART 8
Journal Title: Clinical Infectious Diseases From Free Medical Journals . com (/1997 - /Embargo: 1 year)

From Proquest NHS (12/2004 - 07/2006)
Page: 1157-1164
ISSN: Print: 1058-4838
Search the Web: [article] [author(s)]

Efficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator - associated pneumonia : A multicenter , randomized study
Author(s): Chastre , J . ; Wunderink , R . ; Prokocimer , P . ; Lee , M . ; Kaniga , K . ; Friedland , I .
ISSUE: 2008 ; VOL 36 ; PART 4
Journal Title: Critical Care Medicine From Ovid ( Journals @ Ovid ) via Athens (01/1995 - /) Customer Notes: 1997 v25/1 - Print Location: Macclesfield
Page: 1089-1096
Search the Web: [article] [author(s)]

On the Other Side of Patient Care : Two respiratory therapists tell their stories of what it is like to be on the receiving end of ventilatory care
ISSUE: 2008 ; VOL 32 ; PART 4
Journal Title: AARC Times ( Formerly : AAR Times ) AARC Times ( Formerly : AAR Times )
Page: 44-51
Search the Web: [article]

Emerging Research Fronts Comments

by Fang Gao Smith

It was not known, however, whether compliance with sepsis care bundles has an ... although the patient’s usual destination is an intensive care unit (ICU). ...
http://esi-topics.com/erf/2007/august07-FangGaoSmith.html

Role of sedation and analgesia in mechanical ventilation

Important Note: In some cases the Tables of Contents and article citation information may be available
via MyJournals before the journal issue or article is available from the full text providers.
In these instances, you may not find the article or issue described in the MyJournals Alert when you click to view the article.

Author(s): Carlon , G . C . ; Combs , A .
ISSUE: 2008 ; VOL 36 ; PART 4
Journal Title: Critical Care Medicine
http://www10.tdnet.com/Client_Entrance.asp?action=Catalog&ID_Group=0&ID
_Customer=1090&navigate=Frames.asp?Main_Page=Search/Search_Journals_Fram
es.asp&ID_jrn=7540

From Ovid ( Journals @ Ovid ) via Athens
http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=to
c&D=ovft&AN=00003246-000000000-00000> (01/1995 - /)

Customer Notes: 1997 v25/1 -
Print Location: Macclesfield
Page: 1366-1367

Family member satisfaction with end-of-life decision making in the ICU.

Paper copy available at Health Sciences Library Macclesfield District General Hospital
Accession number & update
18198256 Medline 20080423.
Source Chest, {Chest}, Mar 2008 (epub: 15 Jan 2008), vol. 133, no. 3, p. 704-12, ISSN: 0012-3692.
Author(s) Gries-Cynthia-J, Curtis-J-Randall, Wall-Richard-J, Engelberg-Ruth-A.

Abstract
RATIONALE: Families of ICU patients may be at risk for increased psychological morbidity due to end-of-life decision making. The identification of chart-based quality indicators of palliative care that predict family satisfaction with decision making may help to guide interventions to improve decision making and family outcomes.
OBJECTIVE: To determine patient and family characteristics and chart the documentation of processes of care that are associated with increased family satisfaction with end-of-life decision making for ICU patients.
METHODS: We conducted a cohort study of ICU patients dying in 10 medical centers in the Seattle-Tacoma area. Measurement: Outcomes from family surveys included summary scores for family satisfaction with decision making and a single-item score that indicated feeling supported during decision making. Predictor variables were obtained from surveys and chart abstraction. Main results: The survey response rate was 41% (442 of 1,074 families responded). Analyses were conducted of 356 families with questionnaire and chart abstraction data. Family satisfaction with decision making was associated with the withdrawal of life support, and chart documentation of physician recommendations to withdraw life support, discussions of patients' wishes, and discussions of families' spiritual needs. Feeling supported during decision making was associated with the withdrawal of life support, spiritual care involvement, and chart documentation of physician recommendations to withdraw life support, expressions of families' wishes to withdraw life support, and discussions of families' spiritual needs.

CONCLUSIONS: Increased family satisfaction with decision making is associated with withdrawing life support and the documentation of palliative care indicators including the following: physician recommendations to withdraw life support; expressions of patients' wishes; and discussions of families' spiritual needs. These findings provide direction for future studies to investigate approaches to improving family satisfaction in end-of-life decision making. In addition, because there were few nonwhites in this study, these results may not be generalizable to more diverse populations. Future studies should target diverse populations in order to test whether similar factors are similarly important for end-of-life decision making.