Major asthma guideline update: ICS-LABA as-needed replaces albuterol

Major asthma guideline update: ICS-LABA as-needed replaces albuterol

In their first major update in 30 years, newly published asthma guidelines recommend significant changes to the way physicians treat millions of patients diagnosed with asthma. The Global Initiative for Asthma (GINA) now advises that, in general:  Most people with asthma can now be prescribed just one inhaler: an inhaled corticosteroid-and-long-acting beta agonist (ICS-LABA) combination [... read more]

Glycemic control in the ICU

Glycemic control in the ICU. N Engl J Med 2010; 363:2540-2546

Kavanagh, BP and McCowen, KC.

http://www.nejm.org/doi/full/10.1056/NEJMcp1001115

A 42-year-old man is admitted to the intensive care unit (ICU) with an acute exacerbation of asthma associated with community-acquired pneumonia. He is treated with cefotaxime and azithromycin, nebulized albuterol, and intravenous hydrocortisone. He has no known history of diabetes mellitus. Shortly after admission, his arterial glucose concentration is 105 mg per deciliter (5.8 mmol per liter), and on the next day, it has increased to 195 mg per deciliter (10.8 mmol per liter). His glycated hemoglobin level is 5.3%. Should this elevated glucose level be treated?

Non-invasive positive pressure ventilation for patients with acute exacerbations of asthma.

pp. 59-60
Non-invasive positive pressure ventilation for patients with acute exacerbations of asthma.
Sutton, L.