Ugeskrift for laeger
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It is now documented that intensive care units do consider whether treatments promote "the good" and serve patients best. Uncritical use of technology to prolong the dying process must be avoided, and palliative principles worked out. ⋯ However, there are major differences as to how the law is acted upon. Guidelines for futile intensive care treatment should therefore be worked out, and uncritical referral of patients to the ICU avoided.
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Ugeskrift for laeger · Feb 2007
Comparative Study[Post-specialty training program in intensive care medicine. Nordic and European aspects].
Intensive care medicine has become technically and conceptually more demanding in recent years and this has created a need for improved training and education in this field. In Scandinavia a successful post-specialty training program in intensive care medicine was established in 1998 and so far about 200 physicians have passed the two-year program. This program has contributed to an increased interest in and a development of intensive care medicine - both clinically and scientifically - in the five Scandinavian countries (Denmark, Norway, Sweden, Iceland and Finland).
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Intensive care costs are a challenge to the health care system. Because of a political strategy aiming at competition as well as the documentation of treatment quality, cost-effectiveness evaluations are important in order to clarify the association between quality and the costs of treating critically-ill patients. ⋯ The treatment of critically-ill patients aims at improved health. Cost-effectiveness analyses should therefore include quality variables in that the healthcare system is an integral and inseparable part of society.
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The first multidisciplinary intensive care unit in the world was established at the Copenhagen Municipal Hospital in December 1953. The man behind the concept was the Danish anesthesiologist Bjørn Ibsen (born: 1915). ⋯ It is concluded that despite the increased sophistication of intensive care therapy, it often meets with failure because it is started too late. The development of an early warning system is urgently needed.
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Until recently, critical care therapy practitioners have focused on survival rather than on long-term outcomes. The incidence of physical and neuropsychological dysfunction has been underestimated and underreported after acute critical care illness. Current research indicates that these sequelae are common, may be permanent, and are associated with decreased quality of life. More studies investigating the effects of treatment and rehabilitation therapy on sequelae after intensive therapy are required.