Awareness of current research is a big component of staying up to date in nursing and healthcare and providing evidence-based care. Here’s a look at a selection of the latest studies and practice-changing recommendations.
COVID-19
Survival High with Lung Transplant for COVID-19-Associated ARDS
Journal of the American Medical Association
Chitaru Kurihara, M.D., from Northwestern University in Chicago, and colleagues conducted a retrospective case series of 102 patients who underwent a lung transplant between Jan. 21, 2020, and Sept. 30, 2021, including 30 patients with COVID-19-associated ARDS. The researchers found that the median lung allocation scores were 85.8 versus 46.7 for lung transplant recipients with versus those without COVID-19; median time on the lung transplant waitlist was 11.5 versus 15 days, and 56.7 and 1.4 percent, respectively, used preoperative venovenous extracorporeal membrane oxygenation (ECMO).
ACP Issues Final Practice Points for Remdesivir Use in COVID-19
Annals of Internal Medicine
Anjum S. Kaka, M.D., from the University of Minnesota School of Medicine in Minneapolis, and colleagues updated the living review of remdesivir for adults hospitalized with COVID-19. Based on the evidence from five RCTs, the researchers found that the updated results confirm a 10-day course of remdesivir probably results in little to no reduction in mortality compared with control.
Amir Qaseem, M.D., Ph.D., from the American College of Physicians in Philadelphia, and colleagues updated the living, rapid practice points for the use of remdesivir as a COVID-19 treatment. The authors note that five days of remdesivir should be considered for hospitalized patients with COVID-19 who do not require invasive ventilation or extracorporeal membrane oxygenation (ECMO). Extending remdesivir to 10 days should be considered for patients who develop the need for invasive ventilation or ECMO within a five-day course. Initiation of remdesivir should be avoided for hospitalized patients with COVID-19 who are already on invasive ventilation or ECMO.
Guidelines & Recommendations
Guidelines Issued for Managing Critically Ill Pediatric Patients
Pediatric Critical Care Medicine
Heidi A.B. Smith, M.D., from the Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues developed clinical practice guidelines for critically ill infants and children, focusing on seven domains of care, including analgesia, sedation, delirium, and optimizing the environment. The task force issued 44 recommendations (14 strong and 30 conditional) and five good practice statements.
ACSM Updates Guidance for Exercise in Type 2 Diabetes
Medicine & Science in Sports & Exercise
Jill A. Kanaley, Ph.D., from the University of Missouri in Columbia, and colleagues summarized the current evidence and extended and updated the 2010 recommendations on exercise and type 2 diabetes. The authors note that for adults with type 2 diabetes, regular aerobic exercise training improves glycemic management, with less daily time in hyperglycemia and reductions in overall glycemia. In terms of overall glucose management and attenuation of insulin levels, high-intensity resistance exercise training has greater beneficial effects than low- to moderate-intensity resistance training.
Recommended Adult Immunization Schedule Updated for 2022
Annals of Internal Medicine
According to the guidelines, there are no changes to recommendations for the
Haemophilus influenzae type b and hepatitis A vaccines, while notes were added to other vaccines, including human papillomavirus vaccination. For hepatitis B, universal vaccination is recommended for all adults aged 19 through 59 years and for adults aged 60 years or older at high risk for hepatitis B virus infection. Recommendations for influenza vaccine for the 2021 to 2022 season include routine annual vaccination for all persons aged 6 months and older who do not have contraindications, with no preferential recommendation for one influenza vaccine product over another. Routine vaccination is recommended against pneumococcal infection for all adults aged 65 years or older with one dose of pneumococcal conjugate vaccine (PCV)15 or PCV20; if PCV15 is used, it should be followed by a dose of pneumococcal polysaccharide vaccine-23. Those aged 19 through 64 years with certain underlying medical conditions or other risk factors should also be vaccinated.
Child Developmental Milestone Checklists Updated by CDC, AAP
Pediatrics
The checklists, revised for the first time since their release in 2004, outline developmental milestones for infants and young children, to help identify delays earlier and are part of regular checkups by pediatricians. The checklists previously used 50th percentile milestones, meaning only half of children were expected to achieve the milestone at a given age. The updated checklists ask about milestones 75 percent or more of children can be expected to achieve by a certain age.
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