Short people got no reason gender, height, and disparities in the management of acute lung injury 英文参考文献.docVIP
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Short people got no reason gender, height, and disparities in the management of acute lung injury 英文参考文献
Dickson and Hyzy Critical Care 2011,15:1010
/content/15/6/1010
COMMENTARY
Short people got no reason: gender, height, and
disparities in the management of acute lung injury
Robert P Dickson and Robert C Hyzy*
See related research by Han et al., /content/15/6/R262
a decade after the ARDS Network ARMA trial demon-
Abstract
strated an 8.8% absolute mortality reduc
e
Though the bene?ts of lung protective ventilation
(LPV) in acute lung injury/acute respiratory distress
syndrome (ALI/ARDS) have been known for more
than a decade, widespread clinical adoption has been
slow. Han and colleagues demonstrate that women
with ALI/ARDS are less likely than men to receive
LPV, though this disparity resolves when the analysis
is adjusted for patient height. This analysis identi?es
patient height as a signi?cant factor in predicting
provider adherence with LPV guidelines, and
authors report that among all patients in their study, only
half (53%) received LPV. Unfortunately, this proportion is
similar to other reports in the post-ARMA era, reports
published more than 5 years ago [5,6], suggesting the
lasting impact of this advance may have been limited and
has plateaue
is illustrates the di? culty of changing
practice culture in the intensive care unit: despite the
LPV protocol requiring no new equipment and minimal
additional training, and despite unambiguous evidence of
mortality bene? t [4,7] and a favorable cost-e? ectiveness
pro? le [8], full adoption into clinical practice simply has
not occurred.
illuminates why some disparities in intensive care exist
and how they may be resolved via improved utilization
of evidence-driven protocols.
In the past 15 years, many of the greatest strides in
intensive care have come not from the introduction of
novel pharmaceuticals nor biomedical devices but instead
In this issue of Critical Care, Han and colleagues report from protocolized care delivery. Intervention
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