Crit Care Resusc
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Withdrawal of potentially life-prolonging treatments is a common procedure in most intensive care units. Until recently, quality improvement activities have been hampered by the absence of a clear sense of "best practice" in this complex area. ⋯ A current ICU quality improvement review lists EOL management as a possible audit item (Curtis et al. Crit Care Med 2006; 34: 211). Our study demonstrated the feasibility of developing a quality improvement tool for EOL decision-making and applying it in the intensive care setting. As evidence about the process of EOL decisionmaking accumulates, that process should become a component of quality assurance audit in intensive care.
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Procalcitonin (PCT) is a precursor of the hormone calcitonin and has been proposed as a marker of infection in critically ill patients. We evaluated the role of procalcitonin in the early detection of sepsis in an Australian intensive care-high dependency unit (ICU/HDU). ⋯ The use of PCT as a screening test (PCT >0.85ng/dL) in conjunction with traditional criteria is of value in the early diagnosis of bacterial sepsis in suspected cases in the ICU. PCT appears to be a reliable diagnostic test for bacterial sepsis at levels > 10 ng/dL.