Foundations of Evidence-Based Practice: Critical Care Trial Networks

C ritical care management involves not only a struggle to sort through alarms, tubes, and catheters, but a struggle to find the right scientific evidence upon which to base our management decisions. Our teachers and mentors urge us to deliver an “evidence-based” decision as often as possible. But, in fact, careful examination of our evidence-based medicine decisions suggests that practices in the intensive care unit (ICU) are based on a blend of local, national, and international opinion from thought-leading experts in specific areas of critical care. These opinions often come to us in the form of consensus statements, which are important roadmaps for evidence-based practice. Practice guidelines from consensus statements are forged from available data and experience. Often the only available literature for these guidelines derives from retrospective observations or single-center efforts.