August 2013 critical care journal club: less is more

• Main Author: Raschke RA
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2013-09-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: goal-directed therapy; pulmonary artery catheters; anti-endotoxin antibody; corticosteroids; adult respiratory distress syndrome; ARDS; drotrecogin alfa; insulin; tight control of blood sugar; hypoglycemia; septic shock
• Online Access: http://www.swjpcc.com/critical-care-journal-club/2013/9/4/august-2013-critical-care-journal-club-less-is-more.html

No abstract available. Article truncated at 150 words. Our August journal club reviewed failed efforts to impact the mortality of critical illness over the past 25 years. We looked at six landmark randomized controlled trials with certain things in common. They each addressed treatment of a major aspect of critical illness. Each was well-supported by previous literature, and biologically plausible. Each resulted in a statistically-significant mortality benefit, and was published in a well-respected journal. And each had an immediate, and in many cases, lasting effect on the bedside practice of critical care. Yet the positive result of each of these six studies was subsequently convincingly refuted. It is important to note, that these studies make up a good part of what we’ve learned in critical care over the past 25 years. There have been some influential positive studies as well, but a great deal of effort has been spent implementing evidence-based practice, based on studies that were later …