Intensive care medicine
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Intensive care medicine · Sep 2014
Practice GuidelineConsensus summary statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care : A statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine.
Neurocritical care depends, in part, on careful patient monitoring but as yet there are little data on what processes are the most important to monitor, how these should be monitored, and whether monitoring these processes is cost-effective and impacts outcome. At the same time, bioinformatics is a rapidly emerging field in critical care but as yet there is little agreement or standardization on what information is important and how it should be displayed and analyzed. The Neurocritical Care Society in collaboration with the European Society of Intensive Care Medicine, the Society for Critical Care Medicine, and the Latin America Brain Injury Consortium organized an international, multidisciplinary consensus conference to begin to address these needs. ⋯ The GRADE system was used to develop recommendations based on literature review, discussion, integrating the literature with the participants' collective experience, and critical review by an impartial jury. Emphasis was placed on the principle that recommendations should be based on both data quality and on trade-offs and translation into clinical practice. Strong consideration was given to providing pragmatic guidance and recommendations for bedside neuromonitoring, even in the absence of high quality data.
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Intensive care medicine · Sep 2014
Multicenter Study Observational StudyEligibility for organ donation following end-of-life decisions: a study performed in 43 French intensive care units.
A persistent shortage of available organs for transplantation has driven French medical authorities to focus on organ retrieval from patients who die following the withdrawal of life-sustaining therapy. This study was designed to assess the theoretical eligibility of patients who have died in French intensive care units (ICUs) after a decision to withhold or withdraw life-sustaining therapy to organ donation. ⋯ A significant number of patients who died during the study period in French ICUs under withholding/withdrawal conditions would have been eligible for organ donation. Brain-injured patients were more likely to die in circumstances which would have been compatible with such practice.