Pharmacotherapy
-
To evaluate the clinical application of enteral glutamine supplementation in critically ill patients and compare the frequency of nosocomial infections in these patients with a historical control group in a burn intensive care unit (BICU), and to assess lengths of stay in the hospital and BICU, mortality rates, and safety profile of glutamine. ⋯ Enteral glutamine supplementation was not associated with a change in the cumulative rate of infectious complications compared with the control group, but this was attributed to more cases of bloodstream infections and fewer cases of pneumonia and cellulitis in the glutamine group. Large, prospective, randomized trials designed to detect small but clinically relevant outcomes are needed to definitively determine the effect of enteral glutamine supplementation in the BICU population.
-
To determine whether use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) is associated with a reduced rate of severe sepsis, and to further characterize the effect of statins on the frequency of organ dysfunction in patients with severe sepsis. ⋯ Statins appear to prevent sepsis from becoming severe, most notably through prevention of sepsis-induced hypotension. This potential role for statins in the prevention and treatment of severe sepsis should be further evaluated in a randomized controlled trial.