Checking gastric residuals every six hours achieved nothing but fewer calories

The edition in brief

GASTRIC-PICU randomised 4700 ventilated children across 24 intensive care units to routine six-hourly gastric residual volume checks or none, and found no routine checking non-inferior for survival and ventilator-free days while raising the proportion meeting energy requirements by 72 hours from 76.8% to 80.3%. In infants hospitalised with pertussis at 11 Italian centres, a target trial emulation found azithromycin associated with higher odds of severe disease than clarithromycin, 60% against 33% with a Pertussis Severity Score above 5. A Swedish national cohort of two million births found that infants who did not receive intramuscular vitamin K had 1.52 times the adjusted odds of a bleeding diagnosis and 2.91 times the odds of intracranial bleeding in the first six months, and that non-receipt has more than doubled since 2006. School-age follow-up of the hPOD trial found prophylactic buccal dextrose gel at one hour of age made no difference to neurocognitive impairment at 6 to 7 years, with signals of more emotional and behavioural difficulty. The SMART trial reports clesrovimab well tolerated across two RSV seasons in infants at increased risk, with RSV-associated illness rates comparable to palivizumab in the first season. Ibuprofen oral suspension syringes from one repackager are under recall for cross-contamination.