Critical care medicine
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To highlight the limitations of single-center trials in critical care, using prominent examples from the recent literature; to explore possible reasons for discrepancies between these studies and subsequent multicenter effectiveness trials; and to suggest how the evidence from single-center trials might be used more appropriately in clinical practice. ⋯ We recommend that practice guidelines should rarely, if ever, be based on evidence from single-center trials. Physicians should apply the findings of single-center trials only after careful evaluation of their methodology, and in particular after comparing the context of the trial with their own situation.
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Critical care medicine · Dec 2009
Comparative StudyIncrease in out-of-hospital cardiac arrest attended by the medical mobile intensive care units, but not myocardial infarction, during the 2003 heat wave in Paris, France.
To address the association between the 2003 heat wave in Paris (France) and the occurrence of out-of-hospital cardiac arrest. ⋯ These data suggest that a heat wave may be associated with an increased risk of sudden cardiac death in the population.
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Critical care medicine · Dec 2009
Case ReportsPropofol infusion syndrome in patients with refractory status epilepticus: an 11-year clinical experience.
Propofol is a sedative, anesthetic, and antiepileptic agent that is frequently used in patients with refractory status epilepticus. Propofol infusion syndrome is a feared complication of propofol use, especially at high infusion rates for prolonged periods. The present study describes the use of propofol and its associated complications in patients with refractory status epilepticus. ⋯ The prolonged use of large doses of propofol to treat refractory status epilepticus was associated with significant mortality and morbidity.
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Critical care medicine · Dec 2009
Resident and RN perceptions of the impact of a medical emergency team on education and patient safety in an academic medical center.
To assess the perceptions of residents and RNs about the effects of a medical emergency team on patient safety and their own educational experiences. ⋯ Residents and RNs believe that a medical emergency team improves patient safety in the hospital without compromising educational experiences or skills. Frequency of involvement in the events and the decision to activate the team correlated with more positive attitudes.