Short people got no reason gender, height, and disparities in the management of acute lung injury 英文参考文献.docVIP

Short people got no reason gender, height, and disparities in the management of acute lung injury 英文参考文献.doc

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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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