Table 3 Outcomes of selected interventions
Disease/process | Intervention | Outcome | Study |
|---|---|---|---|
ALI/ARDS | Low tidal volume ventilation with PEEP table | Decrease in mortality and unassisted breathing before discharge to home (39.8 to 31%), and increase in ventilator free days (10 ± 11 to 12 ± 11 days) | ARMA [7] |
Severe sepsis/septic shock | Early goal-directed therapy | Reduction in in-hospital mortality (46.5% to 30.5%) | Rivers et al. [24] |
Liberation from MV support | Spontaneous breathing trials | Reduction in length of MV support (6 days to 4.5 days), and more rapid extubation after meeting criteria (after 1 day rather than 3 days) | Ely et al. [16] |
Sedation | Daily awakenings | Reduction in length of MV support (7.3 days to 4.9 days), and reduction in ICU LOS (9.9 days to 6.4 days) | Kress et al. [15] |
Anemia | Restrictive transfusions | No change in 30-day mortality (18.7% for restrictive group and 23.3% for liberal group); reduction in hospital mortality for restrictive group (28.1% to 22.2%) | Hebert et al. [23] |
Ischemic stroke | tPA within 3 hours | Improved clinical outcome at 3 months as assessed by four outcome measures (Barthel index, modified Rankin scale, Glasgow outcome scale and NIHSS) | NINDS rt-PA [18] |
VT/VF arrest | Hypothermia | Favorable neurologic recovery (55% versus 39%) and decreased mortality at 6 months (55% to 41%) [19]; increased odds ratio for discharge to home or rehabilitation (5.25, 95% CI of 1.47 to 18.76) [20] | Hypothermia After Cardiac Arrest Study Group [19]; Bernard et al. [20] |