Ventilator-associated pneumonia by methicillin-susceptible Staphylococcus aureus: do minimum inhibitory concentrations to vancomycin and daptomycin matter?

The use of vancomycin minimum inhibitory concentration (MIC) as an outcome predictor in patients with methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia has become an important topic for debate in the last few years. Given these previous results, we decided to investigate whether MICs to vancomycin or daptomycin had any effect on the evolution of patients with ventilator-associated pneumonia (VAP) due to MSSA. An observational, retrospective, multicenter study was conducted among patients with MSSA VAP.

[Nursing role in prevention of Ventilator Associated Pneumonia: Spanish project "Neumonìa Zero"].

The incidence of Ventilator Associated Pneumonia (VAP) varies between 8 and 28% on patients with invasive mechanical ventilation, and it is associated with high mortality rates. The international literature indicates that the VAP has some risk factors that cannot be changed and some other that are closely related to nursing care procedures. The aim of this study is to analyze compliance level to the protocol of nursing prevention of the VAP in the ICU of "General Hospital" in Castellon de la Plana (Spain) within the project "Neumonía Zero".

[Noninvasive mechanical ventilation in severe pneumonia due to H1N1 virus].

Objective: The use of noninvasive mechanical ventilation was evaluated in our series of patients admitted to our ICU with pneumonia due to influenza A virus H1N1, assessing the need for intubation, arterial blood gases and clinical improvement, the development of complications and ICU and hospital stay.

Design: Retrospective and observational study.

Setting: ICU of Castellón University General Hospital (Castellón, Spain).

Severe 2009 A/H1N1v influenza in pregnant women in Spain.

Objectives: To describe the severity of the 2009 influenza A/H1N1v illness among pregnant women admitted to Spanish intensive care units.

Design And Patients: Prospective, observational, multicenter study conducted in 148 Spanish intensive care units. We reviewed demographic and clinical data from the Spanish Society of Intensive Care Medicine database reported from April 23, 2009, to February 15, 2010.

[Patient data management systems or unit data management systems. Two clinical management perspectives in Intensive Medicine].

The need of availability of information able to describe the activity performed in ICU has two different sides. The first related with the monitoring of the patient himself, his clinical situation changes and the checking of attitudes and reactions of the clinical team related to these changes. The other one focused on the possibility to describe appropriately the general activity of the unit, the epidemiological characteristics of the attended population and the indicators of efectitivity and efficiency that could be used for a continous quality improving.

[Information strategies in a polyvalent Intensive Care Unit].

Introduction: Understanding the information provided to families and surrogates of the critically ill patients admitted to ICUs and its adequate communication without contradictions, is a fundamental aspect related with the possible participation of these persons in the treatment decision making and with the quality perceived regarding the care process. Our aim in this study is to assess these two aspects (information and communication of information).

Design: Opinion study elaborated by the medical team and nursing staff of a multidisciplinary ICU.

[ Contact isolation and prevention of spreading of serious infections in an intensive care unit. Description of a protocol].

Hospital infection (HI) represents a serious care problem in critical patients. The presence of this complication is associated to an increase in the baseline seriousness of the patient, that is translated into greater care effort, multiplication of workload and greater mortality. This situation is clearly complicated when the causal agent of the infection is a multiresistant bacteria, since it also requires specific measures aimed at avoiding crossed transmission of the infection to other patients in addition to route treatment.

[Care work load in critical patients. Comparative study NEMS versus NAS].

Introduction: The systems of calculating care load have not yet reached the levels of generalized use which the systems of prognostic estimation of survival have. The reason for this is their potential defects of design (medical and not nursing conceptualization) and the sometimes confusing completion (TISS 76). The simplest ("nine equivalents of nurse manpower use score" [NEMS], care levels) add the difficulty of not being useful for the calculation of staff, because the design is not oriented towards nursing.