American Thoracic Society Journal news tips for November 2003 (first issue)

ment with three antibiotics led to improved survival (66 percent versus 54 percent associated with one or two antibiotics), plus decreased cost ($41,483 versus $55,447). Testing with mini-brochoalveolar lavage did not improved survival but did reduce cost ($39,967 down from $41,483), since it lowered antibiotic use per survivor (39 days versus 63). The researchers said that ventilator-associated pneumonia complicates the course of patients on mechanical ventilation in between 8 and 28 percent of the cases. The resulting disease has a mortality rate ranging from 24 to 50 percent, plus it increases the patient's stay in the intensive care unit and hospital. Because of the time that it takes to get the "right" antibiotic therapy, diagnostic testing has not been shown to impact survival. For their research, the investigators used a decision analysis model employing a hypothetical group of immune-competent critically ill patients who were on mechanical ventilation for 7 days. The medical scientists generated a number of possible strategies associated with varied diagnostic paths. The researchers' probability estimates were derived from a literature search of 111 articles on the illness. The research is published in the first issue for November2003 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

Very premature infants can achieve normal surfactant and function

Results from a study of premature infants who were born at from 23 to 31 weeks gestation indicated that they had a surfactant deficiency and dysfunction on their first day of life; however, normal composition and function could occur after their first week of life despite continuing lung disease. The investigators studied tracheal aspirate samples from 35 infants most of whom had been intubated to allow passage of oxygen into their lungs; most had respiratory distress syndrome. The investigators found that surfactant samp

Contact: Cathy Carlomagno
American Thoracic Society

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