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To lower glucose levels in all patients in the intensive care unit (ICU) to the target range of 4.5–7.5 mmol/l using a nurse-driven computerised insulin protocol in combination with bedside glucose measurement. Cohort study. Mixed adult ICU. All 182 patients admitted to the ICU during a 3-month period were studied, except for 3 patients admitted for(More)
OBJECTIVES Deteriorating ward patients are at increased risk. Electronic automated advisory vital signs monitors may help identify such patients and improve their outcomes. SETTING A total of 349 beds, in 12 general wards in ten hospitals in the United States, Europe, and Australia. PATIENTS Cohort of 18,305 patients. DESIGN Before-and-after(More)
OBJECTIVE To evaluate the accuracy of the AccuChek Inform point-of-care glucose measurement device as compared with central laboratory glucose measurement. DESIGN Prospective, observational study. SETTING A ten-bed mixed closed format intensive care unit ina 500-bed general hospital. The unit has a computerized insulin protocol aiming for 81 to 135(More)
Among vasculitis syndromes Wegener's granulomatosis (WG) is characterized by involvement of the upper and lower airways and kidneys. The associated vasculitis involves small and medium sized arteries and veins. Aneurysm formation and a segmental pattern of involvement of larger arteries is not typically seen in WG--a presentation more in keeping with(More)
OBJECTIVE To describe the effect of implementation of a rapid response system on the composite endpoint of cardiopulmonary arrest, unplanned ICU admission, or death. DESIGN Pragmatic prospective Dutch multicenter before-after trial, Cost and Outcomes analysis of Medical Emergency Teams trial. SETTING Twelve hospitals participated, each including two(More)
INTRODUCTION There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these non-technical skills. The present study evaluated the(More)
Introduction There is a growing awareness today that adverse events in the Intensive Care Unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these non-technical skills. The present study evaluated the(More)
OBJECTIVE Hospitalized patients are at risk for adverse events such as unexpected cardiac arrest or admission to an Intensive Care Unit (ICU). Prior to these adverse events these patients often have derangements in vital signs that are not recognized and treated adequately. To identify and treat those patients at risk, our hospital implemented a rapid(More)