Articles: human.
-
Human milk is associated with positive short- and long-term health outcomes. Women's choice to breastfeed is influenced by personal, social, health, and economic factors. The COVID-19 pandemic impacted health care delivery, non-emergent health care services, and family lifestyles, primarily in the early months of 2020. The aim of this study was to determine if breastfeeding initiation rates differed during a global pandemic among women in the military health care system. ⋯ Overall breastfeeding initiation rates did not differ during the COVID-19 pandemic when rates in 2020 were compared to those in the year prior. Race, birth method, parity, and gestational age were associated with breastfeeding initiation rates in women cared for at military centers.
-
Ultrasound is used for peripheral intravenous (PIV) cannulation in patients with difficult landmark-guided IV access in the Emergency Department. Distal-to-proximal application of an Esmarch bandage on the target limb has been suggested as a method for increasing vein size and ease of cannulation. ⋯ This study showed that the use of an Esmarch bandage does not increase basilic vein size in healthy volunteers but is associated with a mild increase in discomfort.
-
Critical care medicine · Jun 2024
Albumin Versus Balanced Crystalloid for the Early Resuscitation of Sepsis: An Open Parallel-Group Randomized Feasibility Trial. The ABC-Sepsis Trial.
International guidelines recommend IV crystalloid as the primary fluid for sepsis resuscitation, with 5% human albumin solution (HAS) as the second line. However, it is unclear which fluid has superior clinical effectiveness. We conducted a trial to assess the feasibility of delivering a randomized controlled trial comparing balanced crystalloid against 5% HAS as sole early resuscitation fluid in patients with sepsis presenting to hospital. ⋯ Our results suggest it is feasible to recruit critically ill patients to a fluid resuscitation trial in U.K. EDs using 5% HAS as a primary resuscitation fluid. There was lower mortality in the balanced crystalloid arm. Given these findings, a definitive trial is likely to be deliverable, but the point estimates suggest such a trial would be unlikely to demonstrate a significant benefit from using 5% HAS as a primary resuscitation fluid in sepsis.
-
Recently, we took care of a teenage boy in our PICU who had been struggling with a lifelong chronic illness and accompanied him and his parents during the last few days of his life. We had the privilege of getting to know him and his parents quite well during the last few years, as he required hospitalization several times during this time. We saw how extremely dedicated his parents had been to him and his care, how they left no stone unturned and sacrificed everything they could to help him have the best quality of life possible. ⋯ I also missed when his funeral took place. I wanted to reach out to his parents, to express how much his life and their love for him had meant to me, too, and to find some closure. So I wrote this short poem for them, and for all the other parents, who have to go through the most difficult time a parent can ever go through-as a pediatric intensivist, a Mom who has never been where they had to go, a fellow human being, and a grieving friend.