Ten take-home messages on vasopressin use in critically ill patients.

The most used vasopressors in critically ill patients are exogenous catecholamines, mainly norepinephrine. Their use can be associated with serious adverse events and even increased mortality, especially if administered at high doses. In recent years, the addition of vasopressin has been proposed to counteract the deleterious effects of high doses of catecholamines (decatecholaminization) with the intention of improving the prognosis of these patients.

Transition from intravenous insulin to subcutaneous long-acting insulin in critical care patients on enteral or parenteral nutrition.

Background And Aims: The optimal initial dose of subcutaneous (SC) insulin after intravenous (IV) infusion is controversial, especially in patients receiving continuous enteral nutrition (EN) or total parenteral nutrition (TPN). The aim of this study was to evaluate the strategy used at our hospital intensive care unit (ICU) in patients switched from IV insulin to SC insulin glargine while receiving EN or TPN.

Design And Methods: A retrospective analysis was made of 27 patients on EN and 14 on TPN switched from IV infusion insulin to SC insulin.

B-type natriuretic peptides for prediction and diagnosis of weaning failure from cardiac origin.

Aim: To evaluate and compare BNP and NT-proBNP concentrations to predict weaning failure from mechanical ventilation (MV) due to heart failure (HF) before a spontaneous breathing trial (SBT) and to identify HF as the cause of failure.

Methods: Prospective, observational study in a university hospital. The sample included 100 patients on MV for over 48 h who underwent an SBT.