The importance of technology for achieving superior outcomes from intensive care

Objective: To test the hypothesis that technology availability, staffing, and diagnostic diversity in an intensive care unit (ICU) are associated with the ability to decrease hospital mortality. Design: Prospective multicenter descriptive cohort study. Setting: Ten Brazilian medical-surgical ICUs. Patients: 1734 consecutive adult ICU admissions. Measurements and results. We recorded the amount of technology, number of diagnoses, and availability of nurses at each ICU. We also used demographic, clinical and physiologic information for an average of 173 admissions to each ICU to calculate standardized mortality ratios (SMRs) for each ICU. The mean SMR for the ten ICUs was 1.67 (range 1.01-2.30). A greater availability of ICU equipment and services was significantly (p < 0.001) associated with a lower SMR. Conclusion. The ability of Brazilian ICUs to reduce hospital mortality is associated with the amount of technology available in these units.