JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study
Protocolized sedation vs usual care in pediatric patients mechanically ventilated for acute respiratory failure: a randomized clinical trial.
Protocolized sedation improves clinical outcomes in critically ill adults, but its effect in children is unknown. ⋯ Among children undergoing mechanical ventilation for acute respiratory failure, the use of a sedation protocol compared with usual care did not reduce the duration of mechanical ventilation. Exploratory analyses of secondary outcomes suggest a complex relationship among wakefulness, pain, and agitation.
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Randomized Controlled Trial Pragmatic Clinical Trial
Chlorhexidine bathing and health care-associated infections: a randomized clinical trial.
Daily bathing of critically ill patients with the broad-spectrum, topical antimicrobial agent chlorhexidine is widely performed and may reduce health care-associated infections. ⋯ In this pragmatic trial, daily bathing with chlorhexidine did not reduce the incidence of health care-associated infections including CLABSIs, CAUTIs, VAP, or C difficile. These findings do not support daily bathing of critically ill patients with chlorhexidine.
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Randomized Controlled Trial
Diagnostic performance by medical students working individually or in teams.
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Randomized Controlled Trial Multicenter Study Observational Study
Association between 7 years of intensive treatment of type 1 diabetes and long-term mortality.
Whether mortality in type 1 diabetes mellitus is affected following intensive glycemic therapy has not been established. ⋯ After a mean of 27 years' follow-up of patients with type 1 diabetes, 6.5 years of initial intensive diabetes therapy was associated with a modestly lower all-cause mortality rate when compared with conventional therapy.