Abstract：
OBJECTIVE:To assess the attitudes of physicians in Milan, Italy, intensive care units (ICUs) regarding end-of-life decisions. DESIGN:Anonymous self-administered questionnaire. SETTING:All 20 ICUs in Milan. PARTICIPANTS:Physicians employed in the ICUs. MEASUREMENTS AND RESULTS:The response rate was 87% (225 of 259). Eighty-two percent of respondents estimated that <10% of deaths in their ICU followed foregoing treatment, whereas 6% estimated that more of 25% deaths followed foregoing treatment. Male gender, long professional experience, and activity mainly in the ICU were significantly associated with greater willingness to forego life-sustaining treatments. Eighty-nine percent of respondents said ethical consultation on end-of-life decisions was never sought; 58% said they would not respect the expressed desire of the patient to forego treatment; and 48% never noted the decision to forgo treatment on the clinical record. After a decision to withdraw treatment, 31% of physicians said they maintained ongoing treatment, but withheld CPR for cardiac arrest; 47% considered withholding and withdrawing life support were not ethically equivalent. CONCLUSIONS:Most physicians considered that most ICU deaths were not the result of deliberately foregoing life support. Although the overall trend was to intervene minimally in patients' dying, individual factors significantly influenced end-of-life decisions. Few physicians sought external ethical advice and decisions were entirely taken by the medical team. Direct involvement of family and treating physician was limited, and the expressed wishes of the patient were generally ignored.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Giannini A,Pessina A,Tacchi EMdoi
10.1007/s00134-003-1919-4keywords:
subject
Has Abstractpub_date
2003-11-01 00:00:00pages
1902-10issue
11eissn
0342-4642issn
1432-1238journal_volume
29pub_type
杂志文章abstract：OBJECTIVE:The aim of this prospective study was to evaluate the value of sinus echography results to directly indicate a transnasal puncture in intubated patients with suspicion of nosocomial maxillary sinusitis. DESIGN:prospective clinical investigation. SETTING:medical intensive care unit. PATIENTS:sixty patients ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-006-0152-3
更新日期：2006-06-01 00:00:00
abstract：PURPOSE:Previous observational studies have inconsistently associated early hyperoxia with worse outcomes after cardiac arrest, and have methodological limitations. We tested this association using a high-resolution database controlling for multiple disease-specific markers of severity of illness and care processes. M...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-014-3555-6
更新日期：2015-01-01 00:00:00
abstract：OBJECTIVE:To evaluate the effectiveness of screening strategy and contact precautions for patients with methicillin-resistant Staphylococcus aureus (MRSA). DESIGN AND SETTING:Prospective observational cohort from 1 February 1995 to 31 December 2001 in three intensive care units (45 beds) in a French teaching hospital....
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-2679-0
更新日期：2005-08-01 00:00:00
abstract：BACKGROUND:Peripherally inserted central venous catheters (PICC) have been proposed as an alternative to central venous catheters (CVC). The aim of this study was to determine the thrombosis rate in relation to PICC placement in patients discharged from the intensive care unit (ICU). METHODS:Data of patients admitted ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-2043-x
更新日期：2011-02-01 00:00:00
abstract：OBJECTIVE:To validate the TRISS method as an audit system on a group of patients with severe trauma admitted to an Italian general intensive care unit (ICU). DESIGN:Prospective, cohort study of consecutive admissions to the ICU. SETTING:A 6-bed general ICU in a 500-bed general hospital. PATIENTS:190 patients with se...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF02044120
更新日期：1996-09-01 00:00:00
abstract：OBJECTIVE:To evaluate the nursing time required for difficult-to-wean patients in a dedicated weaning center (WC) and to examine the correlation of the nursing time with nursing workload (NW) scores and with clinical severity and dependency. SETTING:Four-bed WC of a pulmonary rehabilitation department. INTERVENTION:N...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051249
更新日期：2000-06-01 00:00:00
abstract：:Two hundred and seventy-three acute hemorrhagic shocks were treated in 1984 in a pre-hospital emergency care unit. Twenty patients (7%) had a paradoxical bradycardia: they were conscious, 9 of them had an undetectable systolic arterial pressure with the sphygmomanometric method but the femoral pulse was still present....
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00254705
更新日期：1987-01-01 00:00:00
abstract：:One hundred and eighteen 20-g radial artery catheters were prospectively evaluated in 109 cardiovascular surgical patients. 0.024% papaverine in saline was used as a continuous flushing solution. Using the Doppler method, obstruction of the radial artery with the catheter in situ was found in 11 (9.8%) patients. Decan...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00254675
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVES:We investigated the effect of different levels of continuous positive airway pressure (CPAP) on the cricothyroid (CT; a tensor muscle of the vocal folds) and posterior cricoarytenoid (PCA; sole abductor muscle of the vocal folds) muscles in dogs. DESIGN:Prospective, controlled animal study. SUBJECTS:Nine m...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01709524
更新日期：1996-08-01 00:00:00
abstract：PURPOSE:To examine the association of intravenous iodinated contrast material administration with the subsequent development of post-contrast AKI (PC-AKI), emergent dialysis, and short-term mortality using a propensity score-adjusted analysis of a cohort of intensive care unit (ICU) patients who underwent CT examinatio...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-017-4699-y
更新日期：2017-06-01 00:00:00
abstract：:Arterial catheterization is the second most common invasive procedure performed in the intensive care unit. Despite the ubiquity of the procedure, complications including failure to place the catheter occur. While many clinicians are familiar with the use of ultrasound (US) guidance to decrease complication rates of c...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-009-1699-6
更新日期：2010-02-01 00:00:00
abstract：UNLABELLED:Admission of cancer patients with serious medical complications to the ICU remains controversial primarily because of the high short-term mortality rates in these patients. However, the cancer patient population is heterogeneous regarding age, underlying conditions, and curability of their disease, suggestin...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340051350
更新日期：2000-12-01 00:00:00
abstract：OBJECTIVE:The study was undertaken to determine if critically ill patients under mechanical ventilation could reactivate latent cytomegalovirus (CMV) in either lung or blood. DESIGN:Prospective study in critically ill patients was performed in a multidisciplinary intensive care unit in a university hospital. PATIENTS...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01709343
更新日期：1996-11-01 00:00:00
abstract：OBJECTIVE:The Brugada syndrome is a clinical and electrocardiographic familial entity, which may lead to sudden cardiac death. A Brugada pattern ECG may occasionally be caused by conditions such as an overdose of tricyclic antidepressants (TCA). Toxicity of TCA frequently results in the need for critical care support. ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-005-0007-3
更新日期：2006-02-01 00:00:00
abstract：OBJECTIVES:To investigate at what time the peak level should be determined under conventional thrice daily (t.i.d.) administration of the aminoglycoside netilmicin and to study its serum concentrations under once daily (od) treatment to define the required daily dose and to gain information about convenient drug monito...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01694773
更新日期：1993-01-01 00:00:00
abstract：OBJECTIVE:Pressure-volume (PV) curves are recorded after induction of complete muscle paralysis, which may limit their clinical use. The feasibility of recording PV curves without paralysis has not been tested. In 19 patients with acute respiratory distress syndrome (ARDS) and no hemodynamic instability we prospectivel...
journal_title：Intensive care medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00134-006-0265-8
更新日期：2006-09-01 00:00:00
abstract：OBJECTIVE:To assess the effect of partial liquid ventilation with perfluorocarbons on hemodynamics and gas exchange in large pigs with induced acute lung injury (ALI). DESIGN:Randomized, prospective, double-control, experimental study. Experimental intensive care unit of a university. MATERIALS:Eighteen large pigs (5...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01700657
更新日期：1995-12-01 00:00:00
abstract：:As part of a nationwide evaluation of intensive care, we examined patient- and hospital-related factors which could influence the patterns of utilization of arterial cannulae and central venous and pulmonary artery catheters. We also studied the possible impact of these interventions on the short-term outcome among 14...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01713935
更新日期：1991-01-01 00:00:00
abstract：:Myxoedema coma is a medical emergency with high mortality. In this study, clinical response and plasma variations of thyroid hormones were analysed in 7 patients, 6 presenting with myxoedema coma and one with myxoedema ileus. These patients were treated with intravenous or oral l-thyroxine (l-T4). 1000 mu l-T4 iv were...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01708403
更新日期：1991-01-01 00:00:00
abstract：:Production of beta-lactamases is the most important means of bacterial resistance to beta-lactam antibiotics. The traditional, plasmid-mediated beta-lactamases were initially confined to Enterobacteriaceae but have now spread to other genera and species including Pseudomonas aeruginosa, Haemophilus influenzae, and Nei...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF01745244
更新日期：1994-07-01 00:00:00
abstract：: ...
journal_title：Intensive care medicine
pub_type： 社论
doi：10.1007/s00134-018-5401-8
更新日期：2018-12-01 00:00:00
abstract：PURPOSE:Family members of patients who die in the intensive care unit (ICU) may experience symptoms of stress, anxiety, depression, posttraumatic stress disorder (PTSD), and/or prolonged grief. We evaluated whether grief symptoms were alleviated if the physician and the nurse in charge at the time of death sent the clo...
journal_title：Intensive care medicine
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s00134-016-4669-9
更新日期：2017-04-01 00:00:00
abstract：:Of 28 consecutive patients over 64 years old, in whom endoscopy revealed gastro-duodenal ulcers with signs of recent hemorrhage (active bleeding, non-bleeding vessel or adherent clot), 14 were randomly assigned to receive endoscopic alcoholization of the lesions preceded by intragastric instillation of norepinephrine,...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF01724799
更新日期：1990-01-01 00:00:00
abstract：:Recombinant activated factor VII (rFVIIa, 'NovoSeven') is indicated for the treatment of spontaneous and surgical bleeding in patients with haemophilia A or B with antibodies to factors VIII or IX (FVIII or FIX) worldwide, and in patients with acquired haemophilia in Europe. In vitro cell models have demonstrated that...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-002-1469-1
更新日期：2002-10-01 00:00:00
abstract：OBJECTIVE:To compare available instruments for assessing delirium in critically ill adults that have undergone validity testing and provide clinicians with strategies to incorporate these instruments into clinical practice. DESIGN:Medline (1966-September 2006) was searched using the key words: delirium, cognitive dysf...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-007-0603-5
更新日期：2007-06-01 00:00:00
abstract：:We report a case of hyperinflation induced isorythmic atrio-ventricular dissociation with circulatory failure in a patient with chronic obstructive pulmonary disease. The arrythmia was successfully treated by applying "pressure support ventilation" (PSV: 20 cmH2O) which, by decreasing the respiratory rate and increasi...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00263868
更新日期：1989-01-01 00:00:00
abstract：PURPOSE:To examine the consequences of administration of norepinephrine on muscle tissue oxygenation in severely hypotensive septic shock patients. METHODS:This was a prospective observational study conducted in a medical intensive care unit of a university hospital. We included 28 septic shock patients that received ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-2013-3
更新日期：2010-11-01 00:00:00
abstract：PURPOSE:Rapid shallow breathing may occur at any time during spontaneous breathing trials (SBT), questioning the utility of a single determination of the rapid shallow breathing index (RSBI). We hypothesize that change in RSBI during SBT may more accurately predict successful extubation than a single determination. ME...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1735-6
更新日期：2010-03-01 00:00:00
abstract：:The acute respiratory distress syndrome (ARDS) continues as a contributor to the morbidity and mortality of patients in intensive care units throughout the world, imparting tremendous human and financial costs. During the last ten years there has been a decline in ARDS mortality without a clear explanation. The Americ...
journal_title：Intensive care medicine
pub_type： 共识发展会议,杂志文章,评审
doi：10.1007/s001340050585
更新日期：1998-04-01 00:00:00
abstract：:A retrospective study of the medical records of 115 consecutive cases of meningococcal disease with 11 fatalities was carried out in order to evaluate the power of 15 clinical and laboratory variables available on admission in predicting a fatal outcome. On linear discriminant analysis, six variables showed a signific...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF00261740
更新日期：1986-01-01 00:00:00
