In patients with suspected VAP, Candida spp. airway colonization is frequent and associated with increased risk for MDR bacteria isolation. This could worsen outcome and should therefore be considered when choosing an empiric antibiotic therapy.

The implementation of an active, intensive communication strategy regarding end-of-life care in the ICU was associated with a significant reduction in the rate of burnout syndrome and depression in a stable population of caregiving staff.

Medical Education 2010: 44: 716–722 Objectives  What is the best way to train medical students early so that they acquire basic skills in cardiopulmonary resuscitation as effectively as possible? Studies have shown the benefits of high‐fidelity patient simulators, but have also demonstrated their limits. New computer screen‐based multimedia simulators have fewer constraints than high‐fidelity patient simulators. In this area, as yet, there has been no research on the effectiveness of transfer of learning from a computer screen‐based simulator to more realistic situations such as those encountered with high‐fidelity patient simulators. Methods  We tested the benefits of learning cardiac arrest procedures using a multimedia computer screen‐based simulator in 28 Year 2 medical students. Just before the end of the traditional resuscitation course, we compared two groups. An experiment group (EG) was first asked to learn to perform the appropriate procedures in a cardiac arrest scenario (CA1) in the computer screen‐based learning environment and was then tested on a high‐fidelity patient simulator in another cardiac arrest simulation (CA2). While the EG was learning to perform CA1 procedures in the computer screen‐based learning environment, a control group (CG) actively continued to learn cardiac arrest procedures using practical exercises in a traditional class environment. Both groups were given the same amount of practice, exercises and trials. The CG was then also tested on the high‐fidelity patient simulator for CA2, after which it was asked to perform CA1 using the computer screen‐based simulator. Performances with both simulators were scored on a precise 23‐point scale. Results  On the test on a high‐fidelity patient simulator, the EG trained with a multimedia computer screen‐based simulator performed significantly better than the CG trained with traditional exercises and practice (16.21 versus 11.13 of 23 possible points, respectively; p < 0.001). Conclusions  Computer screen‐based simulation appears to be effective in preparing learners to use high‐fidelity patient simulators, which present simulations that are closer to real‐life situations.

This study shows for the first time that citrate lock reduced catheter complications and increased catheter life span as compared to saline lock in critically ill adults requiring hemodialysis.