A lower blood pressure target for ventilated children used a third less vasopressor with no worse outcomes

The edition in brief

In the PRESSURE trial, 1,900 ventilated children on vasoactive drugs in 23 paediatric intensive care units were randomised to a permissive mean arterial pressure target, above the 5th centile for age, or usual care. The permissive group received 37.5% less vasopressor, and the composite of 30-day mortality and ventilation time did not differ; PICU stay among survivors was slightly shorter. TRIUMPH-2 randomised 1,152 adults with obesity and type 2 diabetes to weekly retatrutide or placebo for 80 weeks: weight fell 11.9% to 18.8% against 5.1%, with more gastrointestinal effects, hypotension and dysaesthesia, and more stopping for adverse events at higher doses. A Swedish case-control study of 624,713 first births found quadrivalent HPV vaccination before pregnancy was associated with slightly lower odds of preterm birth (adjusted OR 0.95) and severe growth restriction, an association rather than proof of effect. The EQUAL ACP cluster trial in 791 older adults with serious illness found facilitated and self-guided advance care planning gave similar completion within each racial group, about seven in ten overall, though the facilitated approach did relatively better among Black participants. The pearl: weight-loss injections need a contraception and pregnancy-planning conversation at the start.