JAMA : the journal of the American Medical Association
-
Lung-protective mechanical ventilation with the use of lower tidal volumes has been found to improve outcomes of patients with acute respiratory distress syndrome (ARDS). It has been suggested that use of lower tidal volumes also benefits patients who do not have ARDS. ⋯ Among patients without ARDS, protective ventilation with lower tidal volumes was associated with better clinical outcomes. Some of the limitations of the meta-analysis were the mixed setting of mechanical ventilation (intensive care unit or operating room) and the duration of mechanical ventilation.
-
Randomized Controlled Trial
Neurocognitive development of children 4 years after critical illness and treatment with tight glucose control: a randomized controlled trial.
A large randomized controlled trial revealed that tight glucose control (TGC) to age-adjusted normoglycemia (50-80 mg/dL at age <1 year and 70-100 mg/dL at age 1-16 years) reduced intensive care morbidity and mortality compared with usual care (UC), but increased hypoglycemia (≤40 mg/dL) (25% vs 1%). ⋯ At follow-up, children who had been treated with TGC during an ICU admission did not have a worse measure of intelligence than those who had received UC.
-
Norovirus outbreaks are common among vulnerable, elderly populations in US nursing homes. ⋯ Norovirus outbreaks were associated with significant concurrent increases in all-cause hospitalization and mortality in nursing homes.