American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jan 2016
Randomized Controlled Trial Multicenter Study Comparative StudyConservative Versus Liberal Oxygenation Targets for Mechanically Ventilated Patients - a Pilot Multicenter Randomized Controlled Trial.
There are no randomized controlled trials comparing different oxygenation targets for intensive care unit (ICU) patients. ⋯ Our study supports the feasibility of a conservative oxygenation strategy in patients receiving IMV. Larger randomized controlled trials of this intervention appear justified. Clinical trial registered with Australian New Zealand Clinical Trials Registry (ACTRN 12613000505707).
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Am. J. Respir. Crit. Care Med. · Jan 2016
Standardized Intensive Care - Protocol Misalignment and Impact Misattribution.
Guidelines, protocols, and checklists (together called "protocols") can be immensely helpful in the clinical arena. However, clinicians and health care systems relying on protocols must assess whether benefits are being accrued, whether such "benefits" are real, and whether harm can be detected. ⋯ We describe two concepts, "protocol misalignment" and "protocol misattribution," and discuss how understanding these concepts might help improve outcome and prevent unanticipated harm. Ultimately, applying protocols to the same standards of proof as other interventions might increase insight and help ensure "true" patient benefit.