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Michael Klompas, Kathleen Speck, Michael D Howell, Linda R Greene, Sean M Berenholtz
IMPORTANCE: Regular oral care with chlorhexidine gluconate is standard of care for patients receiving mechanical ventilation in most hospitals. This policy is predicated on meta-analyses suggesting decreased risk of ventilator-associated pneumonia, but these meta-analyses may be misleading because of lack of distinction between cardiac surgery and non-cardiac surgery studies, conflation of open-label vs double-blind investigations, and insufficient emphasis on patient-centered outcomes such as duration of mechanical ventilation, length of stay, and mortality...
May 2014: JAMA Internal Medicine
Louise Rose, Katie N Dainty, Joanne Jordan, Bronagh Blackwood
BACKGROUND: Weaning from mechanical ventilation is influenced by patient, clinician, and organizational factors. OBJECTIVE: To identify factors that may influence weaning and adoption of weaning strategies and tools, clinicians' perceptions of weaning strategies, and weaning experiences of patients and patients' families. METHOD: A scoping review of indexed and nonindexed publications (1990-2012) was done. Qualitative studies of health care providers, patients, and patients' families involved in weaning were included...
September 2014: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
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