transition point. The cost of transport, measured by respirometry, increased as the fish switched from labriform to undulatory swimming. Our data show that bluegill changed gait as swimming speed increased to recruit additional muscle mass, rather than to maximize economy, as is the case for many terrestrial animals.
The empiric algorithm derived from analysis of local microbiologic data predicted significantly better coverage than one defined by an unmodified guideline-driven approach for early HAP/VAP. Our locally-derived TICU algorithm of ceftriaxone+vancomycin for early pneumonia and piperacillin-tazobactam+vancomycin for late pneumonia optimizes the adequacy of initial therapy. Understanding local patterns of pneumonia ensures the creation and maintenance of empiric algorithms that achieve the best clinical outcomes.
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