tailieunhanh - Báo cáo y học: "Bench-to-bedside review: The MET syndrome – the challenges of researching and adopting medical emergency teams"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Bench-to-bedside review: The MET syndrome – the challenges of researching and adopting medical emergency teams. | Available online http content 12 1 205 Review Bench-to-bedside review The MET syndrome - the challenges of researching and adopting medical emergency teams Augustine Tee Paolo Calzavacca Elisa Licari Donna Goldsmith and Rinaldo Bellomo Department of Intensive Care and Department of Surgery Melbourne University Austin Hospital Studley Road Heidelberg Melbourne Victoria 3084 Australia Corresponding author Rinaldo Bellomo Published 23 January 2008 This article is online at http content 12 1 205 2008 BioMed Central Ltd Critical Care 2008 12 205 doi cc6199 Abstract Studies of hospital performance highlight the problem of failure to rescue in acutely ill patients. This is a deficiency strongly associated with serious adverse events cardiac arrest or death. Rapid response systems RRSs and their efferent arm the medical emergency team MET provide early specialist critical care to patients affected by the MET syndrome unequivocal physiological instability or significant hospital staff concern for patients in a non-critical care environment. This intervention aims to prevent serious adverse events cardiac arrests and unexpected deaths. Though clinically logical and relatively simple its adoption poses major challenges. Furthermore research about the effectiveness of RRS is difficult to conduct. Sceptics argue that inadequate evidence exists to support its widespread application. Indeed supportive evidence is based on before-and-after studies observational investigations and inductive reasoning. However implementing a complex intervention like RRS poses enormous logistic political cultural and financial challenges. In addition doubleblinded randomised controlled trials of RRS are simply not possible. Instead as in the case of cardiac arrest and trauma teams change in practice may be slow and progressive even in the absence of level I evidence. It appears likely that the accumulation of evidence from different .