It has been previously shown that early initiation of feeding may improve nutritional delivery and implementation of local management protocols may facilitate this process [ 6].
Thus, several paediatric intensive care units have reported their experience of improving the delivery of nutritional support and its impact on clinical outcomes by implementation of nutritional management protocols and guidelines [ 5- 7].
Such efforts and better nutritional support practices may be facilitated by increasing nutritional awareness and implementation of local management protocols in routine clinical practice [ 5- 7].
The use of supportive therapies, including high-frequency jet ventilation, inhaled nitric oxide, and extracorporeal life support, was similar between groups as well.Since the implementation of a management protocol for infants with CDH, survival has improved significantly compared with expected survival and preprotocol controls.
This report details our experience with the practical implementation of a management protocol for massive postpartum hemorrhage at a tertiary care hospital in a developing country.
Although implementation of a management protocol for obstetric bleeding that integrates new knowledge in coagulation may aid physicians in improving outcomes for the mother as well as the baby [ 13], consideration also needs to be given to the ubiquitous availability of these newer modalities.
The significant differences in the duration of ventilatory support over time, with a longer duration in the most recent study of 2010, is probably because of the implementation of targeted temperature management protocols, and thus longer sedation.
The timeline for the actual implementation of child pain management protocols and the utilization of paracetamol with circumcision is not known.
The increase in non-pulmonary complications may be explained by the implementation of targeted temperature management protocols, or by higher incidence of aspiration, and thus sicker patients [ 7], which might predispose to infection and consequent multiple organ failure [ 27].
A prospective consecutive series of 818 patients admitted to a trauma ICU found no reduction in mortality or infectious complications in association with the implementation of a normoglycemic management protocol (glucose goal of 80 to 110 mg/dL) [ 47].
