Articles: critical-care.
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Scand J Clin Lab Invest Suppl · Jan 1996
ReviewElevations in blood lactate: overview of use in critical care.
Blood lactate measurements are being used clinically as an indicator of circulatory impairment and the overall state of oxygenation of patients in critical care. This report briefly covers the areas of usage of lactate testing, lactate biochemistry, appropriate sample handling, and clinical interpretation of lactate measurements in critical care monitoring including pediatric cardiac surgery and extracorporeal membrane oxygenation (ECMO).
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Patient data management in anaesthesia and intensive care should include besides medical data of individual patients economically important parameters, e.g. working time or cost of material. Integration of this data management system in the hospital information network enables case-oriented analyses for costs in relation to outcome. Standards of therapy including cost-benefit estimates may be an approach to improve the quality of care and to control the cost of medical care, in particular in the setting of teaching hospitals, avoiding erratic and costly orders by staff in training.
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Critical care clinics · Jan 1996
ReviewEthically based medical decision making in the intensive care unit: residency teaching strategies.
It is important that educators in the intensive care unit (ICU) provide physicians in training with the guidance and experience requisite in developing foundational skills in value-based medical practice. This article discusses the underlying philosophy of ethically based medical decision making and describes the components of an educational program in medical humanities for the ICU. In particular, the authors focus on the central role of a relationship between the patient and the caregiver.
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Critical care clinics · Jan 1996
ReviewCritical care computing: outcomes, confidentiality, and appropriate use.
This article reviews the current limitations of computerized outcome predictor models and severity scoring systems. A logical extension of predictor models, a "computational futility metric," is proposed with a discussion of potential uses and abuses. These types of electronic surveillance will not solve the problem of society's denial of death or resolve the allocation of medical resources. Issues related to the protection of patients and physicians under electronic epidemiologic surveillance are discussed.