The price of this quality assessment is considerable. The workload of this 14-week evaluation resulted in an estimated cost of 20,000 euros.In our view, measurement of VAP incidence has its value as an www.selleckchem.com/products/Tipifarnib(R115777).html intra-hospital quality indicator but not as a benchmark.AbbreviationsVAP: ventilator-associated pneumonia.Competing interestsThe authors declare that they have no competing interests.AcknowledgementsAll participating physicians for the recording of data, Mr H van Assen for providing all APACHE-scores of included patients.
Hyperglycemia in critically ill patients occurs frequently, is associated with increased morbidity and mortality, and studies in adults suggest that tight glycemic control with insulin may improve outcomes [1-14].

Questions regarding safety and efficacy of this therapy, extent of outcome improvement, goal blood glucose (BG) range, and target patient population for treatment are of significant debate [15-18]. However, despite these unresolved issues several medical advisory committees recommend glycemic control as standard care in adults [19-22].Studies regarding hyperglycemia and glycemic control in pediatrics are limited. Those available demonstrate that high BG is prevalent and independently associated with increased morbidity and mortality [5-14]. To date, a single randomized controlled trial to assess whether glycemic control improves outcomes in pediatric critical illness has been published. In this study, although tight glycemic control reduced morbidity and mortality, approximately 25% of patients receiving this management developed severe hypoglycemia [23].

Despite strong data favoring treatment and official recommendations to practice glycemic control in critically ill adults, there are no definitive studies or guidelines to help steer the practice in pediatric critical care.Recent studies indicate that hyperglycemia is a significant concern among physicians caring for critically ill children and suggest that glycemic management is routinely performed [24,25]. Our group developed and published a protocol to identify and manage hyperglycemia in critically ill children and adopted this practice as routine care in our pediatric intensive care unit (ICU) [11,13]. From current literature, however, it is difficult to discern the breadth and extent of actual glycemic control efforts adopted by other pediatric centers.

To better determine how physician attitudes towards glycemic control translate to actual practice we conducted a survey to assess the beliefs and practice habits regarding glycemic control in a cross section of pediatric ICUs in the United States.Materials and methodsWe conducted a survey to ascertain glycemic control beliefs and Carfilzomib practice habits at different pediatric critical care centers in the United States.