New strategies to improve outcomes in the surgical intensive care unit.
BACKGROUND
Over the last half-decade, substantial breakthroughs have taken place in terms of routine therapy of critically ill patients. The combination of these strategies has the potential to result in improvement in the overall outcomes for patients in intensive care units.


METHODS
A focused review was undertaken of trials of interventions in critically ill patients with outcome endpoints.


RESULTS
This review discusses recent results related to transfusion avoidance, new drug therapy of sepsis, low tidal volume ventilation, tight glycemic control, early goal-directed resuscitation in sepsis, and the contribution of intensivists to improved outcomes.


CONCLUSIONS
Appropriate incorporation of these strategies into everyday practice will likely result in improvements in the care of critically ill surgical patients.
Beilman
Greg J
GJ
Department of Surgery, University of Minnesota, North Memorial Medical Center, Robbinsdale, Minnesota, USA. beilm001@umn.edu
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D002423:Cause of Death; D003131:Combined Modality Therapy; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D005791:Patient Care / Q000592:standards* / Q000639:trends; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000009:adverse effects / Q000379:methods; D016019:Survival Analysis
D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D001786:Blood Glucose