JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Comparative Study
Lactate clearance vs central venous oxygen saturation as goals of early sepsis therapy: a randomized clinical trial.
Goal-directed resuscitation for severe sepsis and septic shock has been reported to reduce mortality when applied in the emergency department. ⋯ Among patients with septic shock who were treated to normalize central venous and mean arterial pressure, additional management to normalize lactate clearance compared with management to normalize ScvO2 did not result in significantly different in-hospital mortality.
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Studies suggest that many survivors of critical illness experience long-term cognitive impairment but have not included premorbid measures of cognitive functioning and have not evaluated risk for dementia associated with critical illness. ⋯ Among a cohort of older adults without dementia at baseline, those who experienced acute care hospitalization and critical illness hospitalization had a greater likelihood of cognitive decline compared with those who had no hospitalization. Noncritical illness hospitalization was significantly associated with the development of dementia.