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Shock is characterized by increased serum lactate and tissue hypoperfusion. Hernández and colleagues randomized 424 patients with septic shock and found that a resuscitation strategy targeting normalization of capillary refill time, compared with a strategy targeting serum lactate levels, did not reduce all-cause 28-day mortality. In an Editorial, Angus suggests that these resuscitation strategies are straightforward, inexpensive, and complementary.
Patients with memories of frightening intensive care unit experiences are at risk for longer-term psychological morbidity. Wade and colleagues for the POPPI Trial Investigators randomized 1458 critically ill patients and found that a nurse-led psychological intervention did not reduce the severity of posttraumatic stress. In an Editorial, Kross and colleagues suggest that lessons from this trial could be used to develop other interventions for survivors and their families.
Highlights. JAMA. 2019;321(7):623–625. doi:10.1001/jama.2018.15201
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