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Table 1 Paradigm shifts in intensive care.

From: Paradigm shifts in critical care medicine: the progress we have made

• From small, closed units to larger, more open ICUs
• From a paternal "dictatorship" to more democratic "teamwork"
• Changes in monitoring from intermittent to continuous, invasive to less invasive
• From too much to just enough ...
• Critical illness is not a single phenomenon but part of a patient's disease trajectory
• Expanding beyond the physical ICU structure
• Positive randomized controlled trials are not the only evidence
• Checklists are more helpful than protocols
• Death can be a "good" outcome