Intensive care medicine
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To establish priorities for research in critical care medicine in the UK using survey and nominal group (NG) techniques. ⋯ The intensive care community in the UK appears to prioritise research into organisational aspects of clinical practice and practical aspects of organ-system support. Health services research and the biological sciences need to develop collaborative methods for evaluating interventions and outcomes.
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Intensive care medicine · Oct 2000
Comparative StudyHealth-related quality of life of multiple organ dysfunction patients one year after intensive care.
To assess the quality of life (QOL) of intensive care survivors 1 year after discharge with special emphasis on multiple organ dysfunction (MOD). ⋯ One year after intensive care the survivors had a lower QOL than an age-matched general population with clinically relevant further impairment of MOD patients in vitality and emotional role limitations.
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Intensive care medicine · Oct 2000
Comparative StudyRandomised comparison of partial liquid ventilation, nebulised perfluorocarbon, porcine surfactant, artificial surfactant, and combined treatments on oxygenation, lung mechanics, and survival in rabbits after saline lung lavage.
To compare gas exchange, lung mechanics, and survival to 12 h in surfactant-depleted lung-injured rabbits, treated with partial liquid ventilation (PLV) with perfluorocarbon, nebulised perfluorocarbon, and porcine or artificial surfactant. ⋯ PLV, porcine surfactant and combinations of surfactant with PLV improved oxygenation, Cdyn and survival, but none was clearly superior to the others.
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Physicians are increasingly involved in how their critically ill patients die [72]. The more this happens, the more physicians will have to understand not only how their own backgrounds and biases influence their medical management, but also the cultural and religious backgrounds of the patient and surrogate [72, 73]. The medical profession must realise that, despite tremendous advances in medical knowledge and technology, not everyone can be saved all the time, even in the area of intensive care. ⋯ The patient's code status and the intention of forgoing life-sustaining treatment should be discussed with other members of staff together with the patient and/or family in a compassionate and humane manner. The wishes of the patient and family should be taken into consideration and the physician must try to make an impartial decision by doing what is medically and ethically correct and best for this specific patient. Hopefully, in this way, a more ethical and compassionate approach to end-of-life decisions in the ICU will be obtained.
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Intensive care medicine · Oct 2000
Comparative Study Clinical TrialThe initial distribution volume of glucose rather than indocyanine green derived plasma volume is correlated with cardiac output following major surgery.
To determine whether the initial distribution volume of glucose (IDVG) rather than plasma volume or blood volume is correlated better with cardiac output during the 4 days following major surgery. ⋯ Our results indicate that IDVG rather than intravascular volume is correlated with cardiac output. We suggest that IDVG has potential as an alternative indicator of cardiac preload following major surgery.