By Todd W. Rice, MD

As we reported in Pulmonary Reviews, Todd W. Rice, MD, from Vanderbilt University School of Medicine, Nashville, and colleagues from the NIH ARDS Network conducted the EDEN trial—a randomized multicenter trial of 1,000 patients with acute lung injury—to determine if either trophic or full enteral feeding would reduce ventilator-free days or mortality. This research was presented at the Society of Critical Care Medicine’s 41st Critical Care Congress and also published in the February 22 JAMA. Rice elaborated on the study in his commentary below. (You can also listen to his audiocast.) Please weigh in with your opinion on the topic in the comments.

Mechanically ventilated patients are unable to provide for their own nutrition. Consequently, they are provided artificial nutrition, often in the form of enteral feeds. However, the optimal amount of enteral feeding to provide patients remains unknown, especially early in the critical illness.

By Milena Griffith, PharmD, BCPS

As we reported in Pulmonary Reviews Milena Griffith, PharmD, BCPS, from Midwestern University and Northwestern Memorial Hospital, Chicago, and colleagues wrote a review article published in the March Clinical Infectious Diseases about how anti-infective medication shortages can affect patient care and the measures the US government is taking to prevent deficits. Griffith elaborates on these issues in her commentary below. (You can also listen to her audiocast.) Please weigh in with your opinion on the topic in the comments.

The introduction of the HR 3839 Drug Shortage Prevention Act of 2012 marks the third legislative bill to be put before Congress regarding the issue of overall drug shortages. The large amount of attention that has been directed towards this topic is due to the increase in the number of shortages and the potential impact on patient care.

How often are patients given inappropriate care? According researchers in the January 23 Archives of Internal Medicine, the overuse of medical services—that is, the provision of healthcare services for which the harm outweighs the benefit to the patient or provides no added advantage—may be a bigger problem than is realized. However, there are few studies that describe the overuse of care, they said.

Deborah Korenstein, MD, from Mount Sinai School of Medicine, New York City, and colleagues conducted a literature review and found 172 articles encompassing 241 studies of on the overuse of medical services. The types of services examined in the studies included the following:

• Therapeutic procedures (eg, coronary artery bypass grafting, coronary angiography, carotid endarterectomy)
• Diagnostic tests (eg, upper endoscopy, colonoscopy, plain film radiography, prostate-specific antigen testing)
• Administration of medications and other therapeutics (eg, antibiotics, bronchodilators, acid blockers)