Recently published papers: A series of negative results

Studies with negative results rarely hit the headlines. But the results are often just as important as the positive ones. A number of 'negative headline' studies are looked at in this review: intensive insulin therapy regime, thrombolysis in cardiac arrest, the effects of nutritional guidelines and rapid response outreach teams

Recently published papers: A review of novel strategies in the prevention of hospital-acquired infections, the ability of intensivists to perform echocardiography, and the benefit of polymyxin B haemoperfusion in abdominal sepsis

Chlorhexidine bed baths seem to reduce the incidence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococcus detected by surveillance cultures. There is also some evidence on the benefit of chlorhexidine mouthwashes in the prevention of ventilator-associated pneumonias. Acid-suppressing drugs increase the incidence of hospital-acquired pneumonias in non-intensive care unit patients, although this association has not been shown in the intensive care setting. Intensivists can be trained to perform basic echocardiography in a short period of time, but their errors could lead to incorrect changes in management. Polymyxin B haemoperfusion was shown in interim analysis to improve patients with abdominal sepsis to such an extent that the EUPHAS randomised controlled trial was halted on ethical grounds, although other authors have criticised this decision

Recently published papers: predictors, pressors and poietins

Simple, sensitive and specific predictors of mortality in the critically ill remain elusive goals, and brain natriuretic peptide and venous lactate are the subjects of recent studies. The role of vasopressin in sepsis continues to be the focus of much research interest. Dose ranging studies, potential adverse effects, and selective V1 agonists are discussed below in recent trials. Finally the use of erythropoietin in the critically ill continues to be studied but many continue to urge caution for widespread use outside of clinical trials