Oral decontamination techniques and ventilator-associated pneumonia.

Ventilator-associated pneumonia (VAP) is one of the major nosocomial infections in the intensive care unit (ICU), contributing to increased mortality and morbidity. Studies have shown that oral decontamination through the use of mechanical and pharmacological agents significantly reduces the incidence of VAP, but oral care practices in ICUs are not consistent. A double-blind randomised controlled trial was undertaken in the medical ICU of a tertiary care centre in India, to assess the efficacy of a toothbrush-based oral care technique in reducing incidence of VAP.

Cost-utility in medical intensive care patients. Rationalizing ongoing care and timing of discharge from intensive care.

Rationale: Intensive care unit (ICU) treatment costs pose special challenges in developing countries.

Objectives: To determine the prognostic value of the "utility" score and evaluate the relationship of willingness to pay assessment to utility score during ICU admission.

Methods: We performed a prospective study spanning 12 months in a 24-bed medical ICU in India.