Báo cáo y học: " Ethics roundtable: ‘Open-ended ICU care: Can we afford it" pptx

... patients more cheaply.  at pie can be cut only so many ways. Every day a long-term patient lies in an ICU is a day that resources for other patients diminish commensurately. How long is long ... outcome. © 2010 BioMed Central Ltd Ethics roundtable: ‘Open-ended ICU care: Can we a ord it?’ David Crippen* 1 , Dick Burrows 2 , Nino Stocchetti 3 , Stephan A Mayer 4 , Peter An...

Ngày tải lên: 13/08/2014, 20:21

... causality is difficult; certainly nobody is perfect, but how ‘perfect’ or ‘imperfect’ can physicians and other staff be expected, or allowed, to be? Everyone misses the occasional opportunity to ... this source. Patients can be colonized with MRSA on admission to the ICU. In one study [18] 6.8% of patients were colonized on ICU admission. In addition, in a case–control study as many as...

Ngày tải lên: 12/08/2014, 20:21

... proportion to benefit’. Simply put, we may simply not be able to afford the benefit of the doubt; we will have to take steps to quantify it so that it can be avoided by formal protocol, and not ... answer. If we want enduring change, then we will need to restructure the system at a fundamental level, not merely beat it into submission. Kelly’s reliance on policy making is probably...

Ngày tải lên: 12/08/2014, 18:21

... death. In the ICU the patient is heavily sedated with propofol, but otherwise presumably neurologically intact. Would you want Commentary Ethics roundtable debate: should a sedated dying patient ... family is informed and enquires whether the patient can be aroused so that they may communicate with the patient. An encephalopathy is sometimes part of the multisystem involvement. We ca...

Ngày tải lên: 12/08/2014, 19:22

... the local system may make both issues either easier or more difficult. We should recognize that we care for both patients and families. It is easy to forget that for families the dying process, which ... issues arise from the various perspectives. Futility is a difficult and very value laden concept, and probably does not have a significant role to play here [22]. There needs to be a tran...

Ngày tải lên: 12/08/2014, 20:20

... patients [17], a significant burden of symptoms of post-traumatic stress disorder among family members [18], and a significant amount of conflict within the ICU team or between the team and family members ... the dignity of the dying and ensures the quality of their end of life.” [9] Advance directives Article 7: “Every person of age can prepare advance directives in case they are one day...

Ngày tải lên: 13/08/2014, 11:23

... variability in intensive care. The commentary discusses why variability can nevertheless accurately estimate prognosis and how easily this can be implemented in the critically ill. Keywords heart ... variability decreases. Even low-frequency variability in heart rate – a parameter that traditionally was considered a marker of sympathetic activity in conditions of Commentary Variability sc...

Ngày tải lên: 12/08/2014, 20:20

... consecutive ischaemia play an important role in the development of SAD. In that study [1], the patients were carefully stabilized and CBF was in the normal range. CBF values are expected to vary considerably due ... one could speculate that, in analogy to traumatic brain injury, severe brain dysfunction is necessary to disturb CO 2 reactivity. The action of inflammatory mediators on the endot...

Ngày tải lên: 13/08/2014, 08:21

... is still heavily debated in the US [36-39]. Many practicing surgeons will say that they are already doing Acute Care Surgery – and by many means they probably are correct – e.g. appendicitis, perforated ... may be dismal with high associated morbidity and mortality is often not viewed as rewarding. The global flux of medical students away from general surgical training and trauma surgery in p...

Ngày tải lên: 13/08/2014, 23:20

... JB (Ed): Bayesian Methods and Ethics in Clinical Trial Design. Chichester: John Wiley; 1996. 12. Spiegelhalter DJ, Myles JP, Jones DR, Abrams KR: Bayesian methods in health technology assessment: ... and misleading. They argue that new drugs that reach industry-sponsored phase III trials are more likely to be effective than not, because they reach this stage of testing only if they have sur...

Ngày tải lên: 09/08/2014, 01:24