Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Recently published papers: The message is clear – start early? | Available online http content 8 5 303 Commentary Recently published papers The message is clear - start early Mike Spivey1 and Jonathan Ball2 Registrar ICU Liverpool Hospital Sydney Australia 2Senior Registrar ICU Liverpool Hospital Sydney Australia Correspondence Jonathan Ball jball@ Published online 6 September 2004 This article is online at http content 8 5 303 2004 BioMed Central Ltd Critical Care 2004 8 303-305 DOI cc2957 Abstract Recent papers discussed include a positive trial of early tracheostomy two negative studies of targeted noninvasive ventilation the long awaited results of the high versus low positive end-expiratory pressure Acute Respiratory Distress Syndrome Clinical Trial Network trial and a simple but illuminating study into prognostic markers and end-points of resucitation. Keywords ARDS lactate noninvasive ventilation percutaneous tracheostomy When one admits that nothing is certain one must I think also admit that some things are more nearly certain than others Bertrand Russell From Am I An Atheist Or An Agnostic 1947 English author mathematician and philosopher 1872-1970 Intuitively early definite therapy should produce outcome advantages. However providing evidence to support this has been limited. Several recent studies discussed below add credence to this idea. Early tracheostomy saves lives The detrimental consequences of long-term oral and nasal intubation in critically ill patients are well established. The clinicians dilemma has always been one of deciding which patients will benefit from tracheostomy and crucially when to perform it. August saw the publication of a well designed trial by Rumbak and colleagues 1 that addressed this issue in severely ill patients. They randomly assigned 120 patients who had required intubation for respiratory failure either to early percutaneous tracheostomy within 48 hours or to delayed tracheostomy at 14-16 days . Inclusion criteria were strictly defined in
