Calcium Administration Is Associated with Adverse Outcomes in Critically Ill Patients Receiving Parenteral Nutrition: Results from a Natural Experiment Created by a Calcium Gluconate Shortage.

Study Objective: Parenteral calcium is frequently administered to critically ill patients. However, animal studies demonstrate that calcium administration during critical illness heightens inflammation and leads to shock, organ dysfunction, and mortality. We sought to evaluate the association between calcium administration and adverse outcomes in critically ill patients receiving parenteral nutrition (PN).

Copper and Zinc Deficiency in a Patient Receiving Long-Term Parenteral Nutrition During a Shortage of Parenteral Trace Element Products.

Drug shortages in the United States, including parenteral nutrition (PN) components, have been common in recent years and can adversely affect patient care. Here we report a case of copper and zinc deficiency in a patient receiving PN during a shortage of parenteral trace element products. The management of the patient's deficiencies, including the use of an imported parenteral multi-trace element product, is described.

Vascular catheter tip cultures for suspected catheter-related blood stream infection in the intensive care unit: a tradition whose time has passed?

Background: Catheter-related blood stream infections (CR-BSIs) are estimated to occur in 80,000 patients in intensive care units (ICUs) each year in the United States. We sought to determine the clinical utility of vascular catheter cultures in critically ill patients with suspected CR-BSI.

Methods: We reviewed retrospectively all positive (≥15 colony forming units/roll) vascular catheter tip cultures (CTCs) documented over a four-year period in the ICUs of two hospitals.

Successful use of fondaparinux for bridging early after aortic and mitral mechanical heart valve replacement.

Objective: To report a case of successful use of fondaparinux for bridging early after aortic and mitral mechanical heart valve replacement (MHVR).

Case Summary: A 71-year-old female underwent aortic and mitral valve replacements with St. Jude medical bileaflet prostheses, as well as DeVega tricuspid annuloplasty and coronary artery bypass graft.

Women as authors in the pharmacy literature: 1989-2009.

Purpose: Trends in the authorship of original research articles by female U.S. pharmacists in three peer-reviewed pharmacy journals over the period 1989-2009 were evaluated.

Prevalence of articles with honorary and ghost authors in three pharmacy journals.

Purpose: The prevalence of honorary and ghost authors in articles published in 2009 in three peer-reviewed pharmacy journals was studied.

Methods: A 20-question survey was e-mailed to corresponding authors of articles with two or more authors published in 2009 in the American Journal of Health-System Pharmacy, Annals of Pharmacotherapy, and Pharmacotherapy. The survey solicited the following information: demographic characteristics of the corresponding author, information about the published article, information to determine whether any of the authors did not meet the International Committee of Medical Journal Editors criteria for authorship, and information to determine if an individual contributed substantially to the research or writing of the article but was not listed as an author.

Authorship and characteristics of articles in pharmacy journals: changes over a 20-year interval.

Background: To our knowledge, no studies have evaluated authorship patterns and characteristics of articles in pharmacy journals.

Objective: To investigate changes over a 20-year period in authorship and characteristics of articles in pharmacy journals.

Methods: All articles published in the American Journal of Health-System Pharmacy, The Annals of Pharmacotherapy, and Pharmacotherapy in 1989, 1999, and 2009 were reviewed.

Physical compatibility of 4% sodium citrate with selected antimicrobial agents.

Purpose: The physical compatibility of 4% sodium citrate with vancomycin, gentamicin, tobramycin, daptomycin, and linezolid was evaluated.

Methods: Admixtures were prepared by mixing 4% sodium citrate with clinically relevant concentrations of antimicrobial agents (vancomycin 5 mg/mL, vancomycin 10 mg/mL, vancomycin 20 mg/mL, daptomycin 5 mg/mL, gentamicin 2.4 mg/mL, tobramycin 2.

Daily interruption of sedation in patients treated with mechanical ventilation.

Purpose: The evidence evaluating daily interruption of sedation (DIS) in mechanically ventilated patients, the benefits of this intervention, and the barriers to its incorporation into clinical practice are reviewed.

Summary: Recent epidemiologic studies have identified a high prevalence of oversedation in the intensive care unit (ICU). The practice of DIS, which involves withholding all sedative and analgesic medications until patients are awake on a daily basis, can limit excessive sedation.