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This issue deals with two key topics in the ongoing discussion about how critical care should be organized: rapid response systems (also called medical emergency teams or rapid response teams) for identifying patients not in ICUs who are at risk for life-threatening deterioration, and around-the-clock intensivist staffing in the ICU.
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In the past decade, rapid response teams (RRTs) were broadly implemented to identify and treat patients on medical and surgical wards at risk for catastrophic deterioration and thus prevent death.
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Utilization of computed tomography (CT) scans has increased markedly in the past decades. It is estimated that more than 75 million scans are performed annually in the United States, compared to only 3 million in 1980.
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Early antibiotic administration was associated with reduced likelihood of death, mechanical ventilation, and readmission (but increased risk of Clostridium difficile infection) among patients hospitalized for acute exacerbations of COPD.
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Serious infections caused by Acinetobacter baumannii are appearing in the community, spread by patients who acquired the organism in the hospital setting, and conversely, the organism is being introduced into the hospital from long-term nursing care patient settings. Resistance to antimicrobial agents has increased over the six-year study period, along with the severity of disease.
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The use of angiotensin converting enzyme (ACE) inhibitors in all acute myocardial infarction (MI) patients is controversial. Thus, these investigators from the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) examined the association between ACE inhibitor therapy and mortality in unselected patients with acute MI.
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In this retrospective study of patients hospitalized because of severe chronic liver disease, venous thromboembolism was relatively common and "auto-anticoagulation" in the form of an elevated INR had no apparent protective effect.
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