TY - JOUR
T1 - Struggle for implementation of new strategies in intensive care medicine: anticoagulation, insulin, and lower tidal volumes
AU - Schultz, Marcus J.
AU - Wolthuis, Esther K.
AU - Moeniralam, Hazra S.
AU - Levi, Marcel
PY - 2005
Y1 - 2005
N2 - The management of intensive care patients have changed dramatically in the last years: from merely supportive care, it has moved to evidence-based strategies that have been demonstrated to reduce mortality of the severely ill patients. Clinical research have brought numerous positive clinical trials offering intensive care physicians specific therapies to improve outcome of intensive care patients. Among them were the trials that tested the infusion of activated protein C in patients with severe sepsis, tight glycemic control in surgical intensive care patients, and use of lung protective mechanical ventilation by using small tidal volumes in patients with acute lung injury. Although results of these trials were sufficiently strong to, at least, consider implementation of these strategies in critical care medicine, published and yet unpublished reports show that there is significant struggle with implementation of these therapies. This manuscript focuses on the potential reasons that underlie this problem
AB - The management of intensive care patients have changed dramatically in the last years: from merely supportive care, it has moved to evidence-based strategies that have been demonstrated to reduce mortality of the severely ill patients. Clinical research have brought numerous positive clinical trials offering intensive care physicians specific therapies to improve outcome of intensive care patients. Among them were the trials that tested the infusion of activated protein C in patients with severe sepsis, tight glycemic control in surgical intensive care patients, and use of lung protective mechanical ventilation by using small tidal volumes in patients with acute lung injury. Although results of these trials were sufficiently strong to, at least, consider implementation of these strategies in critical care medicine, published and yet unpublished reports show that there is significant struggle with implementation of these therapies. This manuscript focuses on the potential reasons that underlie this problem
U2 - https://doi.org/10.1016/j.jcrc.2005.05.007
DO - https://doi.org/10.1016/j.jcrc.2005.05.007
M3 - Article
C2 - 16253786
SN - 0883-9441
VL - 20
SP - 199
EP - 204
JO - Journal of Critical Care
JF - Journal of Critical Care
IS - 3
ER -