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Editorials |

Improving Outcomes in the ICU Setting : Are We Effectively Using all of the Information That Is Potentially Available to Us?

Marin H. Kollef, MD, FCCP (St. Louis, MO)
Author and Funding Information

Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Washington University School of Medicine; Director, Medical Intensive Care Unit, Barnes Jewish Hospital; and Director, Respiratory Care Services, Barnes Jewish Hospital.

Correspondence to: Marin H. Kollef, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Campus Box 8052, 660 South Euclid Avenue, St. Louis, MO 63110; e-mail: mkollef@pulmonary.wustl.edu



Chest. 1999;115(6):1490-1492. doi:10.1378/chest.115.6.1490
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The complexity of patients cared for in modern ICUs, along with continuing advances in the technology of critical care and the escalating costs associated with providing that care, have been factors motivating critical care practitioners to identify and implement “best” medical practices.1 Individual best practices are often determined based on their association with improvements in patient outcomes, increased efficiency and cost-effectiveness of medical care, or both of these criteria. These practices should ideally be determined based on sound medical evidence obtained from rigorously performed clinical trials, the most rigorous being randomized controlled trials. However, such trials have often not been performed for many aspects of critical care medicine, including the optimal utilization of neuromuscular blocking agents in the ICU setting. Outcomes research is an emerging field that attempts, in part, to use variations in medical practices to identify important associations between such practices and clinical outcomes.2 As reported in this issue of CHEST (see page 1627), Behbehani and coworkers performed a retrospective cohort study to determine the incidence of acute myopathy in asthma patients requiring mechanical ventilation at two medical centers in Vancouver, Canada.


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