Can you tell your patients how likely they are to return home, to be independent? The “chronically critically ill” are intensive care unit (ICU) patients who survive an initial life-threatening illness, but remain dependent on high-technology ICU services. Increasingly, survival is not the only important outcome: functional status, independence, ability to live at home, and burden on family may be more important.

Daly et al investigated likely outcomes for such patients and found the following:

See Article, pp 456–465

Does the protocol for oral care in your unit, especially for mechanically ventilated patients, include chlorhexidine (CHX)? Within 48 hours of critical illness, oral flora change to virulent flora that include those responsible for ventilator-associated pneumonia (VAP).

In this issue, Munro et al report their evaluation of both toothbrushing and CHX to reduce VAP. The authors evaluated the effect of the following 4 oral care protocols on VAP:

CHX reduced VAP...

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