Care at the end of life in critically ill patients: the European perspective.

Abstract:

PURPOSE OF REVIEW:Care surrounding end-of-life has become a major topic in the intensive care medicine literature. Cultural and regional variations are associated with transatlantic debates about decisions to forego life-sustaining therapies and lead to recent international statements. The aim of this review is to provide insight into the decisions to forego life sustaining therapies and end-of-life care in Europe. RECENT FINDINGS:Although decisions to forego life-sustaining therapies are increasingly made in European countries, frequency and characteristics of end-of-life care are still heterogeneous. Moreover, even though many determinants of these variations have been identified, epidemiologic and interventional studies still provide additional information. In agreement with public opinions, recent European laws have emphasized the patient's autonomy. In real life, advance care planning is rarely used. Decisions are often made by caregivers (physicians and nurses) or families, these latter being less involved than in North America. Not only ethic divergences between physicians but also cultural variations account for this disparity. SUMMARY:To optimize end-of-life care in the intensive care unit, there is an urgent need for the development of palliative and multidisciplinary care in Europe. Furthermore, it highlights the need for culturally competent care, adapted to needs and values of every single patient and family. In addition, a lack of communication with families and within the medical team, an uninformed public about end-of-life issues, and insufficient training of intensive care unit staff are crucial barriers to end-of-life care development. Special awareness of professionals and innovative research are needed to promote a high-standard of end-of-life care in the intensive care unit.

journal_name

Curr Opin Crit Care

authors

Fassier T,Lautrette A,Ciroldi M,Azoulay E

doi

10.1097/01.ccx.0000184299.91254.ff

keywords:

subject

Has Abstract

pub_date

2005-12-01 00:00:00

pages

616-23

issue

6

eissn

1070-5295

issn

1531-7072

pii

00075198-200512000-00019

journal_volume

11

pub_type

杂志文章,评审
  • Clinical trials in ventilator treatment: current perspectives and future challenges.

    abstract:PURPOSE OF REVIEW:Mortality/morbidity-based end points have been useful in evaluating treatments that modulate 'mediator variables' with a large effect size. Ventilation is usually a supportive measure, and hence is best seen as a 'moderator variable'. It can, therefore, have only a modest impact on disease-specific mo...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/mcc.0b013e32833548cf

    authors: Edwards D,Nirmalan M

    更新日期:2010-02-01 00:00:00

  • The science and art of pediatric critical care nutrition.

    abstract:PURPOSE OF REVIEW:Nutritional status and nutrient delivery during critical illness impact clinical outcomes. We have reviewed recent studies that may guide best practices regarding nutrition therapy in critically ill children. RECENT FINDINGS:Malnutrition is prevalent in the pediatric ICU population, and is associated...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000316

    authors: Martinez EE,Mehta NM

    更新日期:2016-08-01 00:00:00

  • Inflammation and cardiovascular diseases: lessons that can be learned for the patient with cardiogenic shock in the intensive care unit.

    abstract:PURPOSE OF REVIEW:In the past 12 years, atherosclerosis and the acute coronary syndromes have turned out to be thromboinflammatory diseases. Recent data suggest that inflammation also plays an important role in the pathogenesis and outcome of cardiogenic shock. This review will summarize recent advances in the understa...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000139364.53198.fd

    authors: Geppert A,Huber K

    更新日期:2004-10-01 00:00:00

  • A history of outcome prediction in the ICU.

    abstract:PURPOSE OF REVIEW:There are few first-hand accounts that describe the history of outcome prediction in critical care. This review summarizes the authors' personal perspectives about the development and evolution of Acute Physiology and Chronic Health Evaluation over the past 35 years. RECENT FINDINGS:We emphasize what...

    journal_title:Current opinion in critical care

    pub_type: 历史文章,杂志文章,评审

    doi:10.1097/MCC.0000000000000138

    authors: Zimmerman JE,Kramer AA

    更新日期:2014-10-01 00:00:00

  • EBM vs. EBM: combining evidence-based and experienced-based medicine in resuscitation research.

    abstract:PURPOSE OF REVIEW:To discuss the clear rationale for evidence-based medicine (EvBM) in the challenging realms of resuscitation research, yet also provide case examples in which even the well designed, multicentered randomized clinical trial may have had unrecognized limitations, and thus misleading results. This is whe...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000413

    authors: Pepe PE,Aufderheide TP

    更新日期:2017-06-01 00:00:00

  • Safety of vitamin C in sepsis: a neglected topic.

    abstract:PURPOSE OF REVIEW:Although vitamin C is essentially a nontoxic vitamin; however, it is important to be aware regarding the safety of high doses before the wide clinical use. RECENT FINDINGS:Minor side effects of vitamin C have been reported, many being reported in earlier studies. High doses of vitamin C (up to 1.5 g/...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000622

    authors: Khoshnam-Rad N,Khalili H

    更新日期:2019-08-01 00:00:00

  • Statins in the intensive care unit.

    abstract:PURPOSE OF REVIEW:Statins are effective lipid-lowering agents used extensively in medical practice. This review summarizes the evidence for statin treatment of cardiovascular patients in the intensive care unit and briefly discusses the role of statins in prevention and treatment of sepsis as a potential future applica...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000235207.00322.96

    authors: Merx MW,Weber C

    更新日期:2006-08-01 00:00:00

  • Long-term outcome after acute lung injury.

    abstract:PURPOSE OF REVIEW:As incidence of acute lung injury (ALI) increases and case fatality decreases, long-term care of survivors is of public health importance. Previous studies demonstrate that these survivors are at risk for impairment in physical, cognitive and mental health. In this review, we will discuss recent studi...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e32834f186d

    authors: Hough CL,Herridge MS

    更新日期:2012-02-01 00:00:00

  • Trauma rehabilitation outcome scoring.

    abstract:PURPOSE OF REVIEW:Appropriate measurements of success in trauma systems are evolving. We review the rationale behind prior trauma and rehabilitation outcomes measures, and how they have led to the current rehabilitation tools in use today. In addition, we review the difficulties with current methods and future improvem...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e328307f25f

    authors: Horwitz DA,Schuerer DJ

    更新日期:2008-08-01 00:00:00

  • How should we treat acinetobacter pneumonia?

    abstract:PURPOSE OF REVIEW:To describe recent data about Acinetobacter baumannii pneumonia epidemiology and the therapeutic options including adjunctive nebulized therapy. RECENT FINDINGS:A. baumannii is a major cause of nosocomial pneumonia in certain geographic areas affecting mainly debilitated patients, with prolonged hosp...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000649

    authors: Amaya-Villar R,Garnacho-Montero J

    更新日期:2019-10-01 00:00:00

  • Nosocomial pneumonia: emerging concepts in diagnosis, management, and prophylaxis.

    abstract::Nosocomial pneumonia is a dynamic disease with multiple etiologic agents and a changing natural history. The highest attack rates and mortality occur in patients with ventilator-associated pneumonia. Diagnosis of nosocomial pneumonia is often made by clinical criteria that are sensitive but lack specificity. The use o...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200210000-00009

    authors: Craven DE,De Rosa FG,Thornton D

    更新日期:2002-10-01 00:00:00

  • Gut dysfunction in the ICU: diagnosis and management.

    abstract:PURPOSE OF REVIEW:Progress has been made in our understanding of gut dysfunction in critical illness. This review will outline new findings and give perspectives based on previous knowledge and concurrent advances in nutrition. RECENT FINDINGS:The relationship between gut dysfunction and poor outcomes in critical illn...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章

    doi:10.1097/MCC.0000000000000813

    authors: Chapple LS,Plummer MP,Chapman MJ

    更新日期:2021-01-21 00:00:00

  • Myocardial protection during resuscitation from cardiac arrest.

    abstract:PURPOSE OF REVIEW:Successful treatment of cardiac arrest requires that an electrically stable and mechanically competent cardiac activity be promptly reestablished. However, many interventions used to attempt to reestablish cardiac activity may also inflict additional myocardial injury and, in turn, compromise resuscit...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200306000-00005

    authors: Gazmuri RJ,Ayoub IM,Kolarova J

    更新日期:2003-06-01 00:00:00

  • Cardiogenic pulmonary edema: mechanisms and treatment - an intensivist's view.

    abstract:PURPOSE OF REVIEW:This review summarizes current understanding of the pathophysiology of cardiogenic pulmonary edema, its causes and treatment. RECENT FINDINGS:The pathobiology and classification of pulmonary edema is more complex than the hydrostatic vs. permeability dichotomy of the past. Mechanisms of alveolar flui...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000626

    authors: Ingbar DH

    更新日期:2019-08-01 00:00:00

  • Role of intestinal epithelial apoptosis in survival.

    abstract:PURPOSE OF REVIEW:To outline evidence that suggests increased intestinal epithelial apoptosis (programmed cell death) plays an important role in critical illness of infectious and noninfectious origin. RECENT FINDINGS:Both human and animal studies demonstrate that the gut epithelium has increased levels of cellular de...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200304000-00013

    authors: Husain KD,Coopersmith CM

    更新日期:2003-04-01 00:00:00

  • Postcardiac arrest temperature management: infectious risks.

    abstract:PURPOSE OF REVIEW:Therapeutic hypothermia following out-of-hospital cardiac arrest improves neurological recovery. Coupled with neurological benefit, multiple complications including infection have been associated with therapeutic hypothermia following out-of-hospital cardiac arrest. In this review, we will discuss the...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000125

    authors: Kuchena A,Merkel MJ,Hutchens MP

    更新日期:2014-10-01 00:00:00

  • Percutaneous left ventricular assist devices for treatment of patients with cardiogenic shock.

    abstract:PURPOSE OF REVIEW:This review will discuss the rationale and clinical utility of percutaneous left ventricular assist devices in the management of patients with cardiogenic shock. RECENT FINDINGS:Left ventricular assist devices maintain partial or total circulatory support in case of severe left ventricular failure. C...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3282efd5bc

    authors: Windecker S

    更新日期:2007-10-01 00:00:00

  • Enhanced recovery pathways as a way to reduce surgical morbidity.

    abstract:PURPOSE OF REVIEW:The aim of this review is to summarize important publications in enhanced recovery during 2010-2011 and to highlight key themes. Specifically, we focus on updated systematic reviews of high-quality clinical trials of enhanced recovery in colorectal surgery, exemplar studies of enhanced recovery in oth...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3283558968

    authors: Grocott MP,Martin DS,Mythen MG

    更新日期:2012-08-01 00:00:00

  • Perioperative fluids: a clear road ahead?

    abstract:PURPOSE OF REVIEW:There is significant controversy for perioperative fluid management. This review discusses the evidence from clinical studies, basic research, and systematic reviews to provide a summary of the current best practice in this area. RECENT FINDINGS:Recent evidence has challenged the long-held contention...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3283632f1f

    authors: Peng ZY,Kellum JA

    更新日期:2013-08-01 00:00:00

  • Acute coagulopathy of trauma: mechanism, identification and effect.

    abstract:PURPOSE OF REVIEW:Acute coagulopathy of trauma has only been described relatively recently. Developing early in the postinjury phase, it is associated with increased transfusion requirements and poor outcomes. This review examines the possible initiators, mechanism and clinical importance of acute coagulopathy. RECENT...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3282f1e78f

    authors: Brohi K,Cohen MJ,Davenport RA

    更新日期:2007-12-01 00:00:00

  • Antioxidant therapy in intensive care.

    abstract:PURPOSE OF REVIEW:This review intends to summarize the recent findings regarding the presence of increased oxidative stress in critically ill patients and its potential pathophysiologic role, as well as the results of recent clinical trials of antioxidant therapies. RECENT FINDINGS:Several lines of evidence confirm th...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200308000-00003

    authors: Lovat R,Preiser JC

    更新日期:2003-08-01 00:00:00

  • Moderate hypothermia in severe head injuries: the present and the future.

    abstract::The use of therapeutic moderate hypothermia for treating severe traumatic brain injury has been reported for more than 50 years. However, the most intense investigation of this treatment has occurred during the last 10 to 15 years. Virtually all preclinical studies have documented a robust treatment effect, not only i...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200204000-00004

    authors: Marion DW

    更新日期:2002-04-01 00:00:00

  • Quality of life and prognosis among survivors of out-of-hospital cardiac arrest.

    abstract:PURPOSE OF REVIEW:We reviewed the topic of quality of life and prognosis of out-of-hospital cardiac arrest survivors, focusing on more recent developments. RECENT FINDINGS:In 2003 to 2004, published experiences from Canada, the United States, and Europe indicate that the quality of life among out-of-hospital cardiac a...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccx.0000125494.84614.fb

    authors: Rea TD,Paredes VL

    更新日期:2004-06-01 00:00:00

  • New insights into the gut as the driver of critical illness and organ failure.

    abstract:PURPOSE OF REVIEW:The gut has long been hypothesized to be the 'motor' of multiple organ dysfunction syndrome. This review serves as an update on new data elucidating the role of the gut as the propagator of organ failure in critical illness. RECENT FINDINGS:Under basal conditions, the gut absorbs nutrients and serves...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000386

    authors: Meng M,Klingensmith NJ,Coopersmith CM

    更新日期:2017-04-01 00:00:00

  • Traumatic brain injury.

    abstract:PURPOSE OF REVIEW:Management of the patient with traumatic brain injury is a rapidly advancing field, characterized in recent years by an improved understanding of intracranial pathophysiology and ways in which outcomes can be improved. Many traditional therapies, such as fluid restriction and hyperventilation, have be...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200312000-00007

    authors: Dutton RP,McCunn M

    更新日期:2003-12-01 00:00:00

  • Should we abandon corticosteroids during septic shock? No.

    abstract:PURPOSE OF REVIEW:With the publication of the results of the recent CORTICUS trial, stress ('low') doses of corticosteroids for the treatment of vasopressor-dependent septic shock in adults can still be considered controversial. The purpose of this narrative review is to elaborate the pros and cons of this treatment in...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e328306a01d

    authors: Groeneveld AB,Molenaar N,Beishuizen B

    更新日期:2008-08-01 00:00:00

  • Prevention of acute respiratory distress syndrome.

    abstract:PURPOSE OF REVIEW:The paucity of effective therapeutic interventions in patients with the acute respiratory distress syndrome (ARDS) combined with overwhelming evidence on the importance of timely implementation of effective therapies to critically ill patients has resulted in a recent shift in ARDS research. Increasin...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0000000000000174

    authors: Festic E,Kor DJ,Gajic O

    更新日期:2015-02-01 00:00:00

  • Technologic advances and program initiatives in public access defibrillation using automated external defibrillators.

    abstract::Widespread provision of early defibrillation following cardiac arrest holds major promise for improved survival from ventricular fibrillation. The critical element in predicting a successful outcome is the rapidity with which defibrillation is achieved. A worldwide awareness of this potential and its advocacy by such ...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/00075198-200106000-00002

    authors: White RD

    更新日期:2001-06-01 00:00:00

  • Patient-related risk factors for postoperative adverse events.

    abstract:PURPOSE OF REVIEW:The risk of adverse outcome in patients undergoing major surgery is affected both by cardiorespiratory fitness, and the presence and severity of comorbidities. Accurate risk stratification is essential for the identification of patients who may benefit from specific perioperative management strategies...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e32832e067c

    authors: Moonesinghe SR,Mythen MG,Grocott MP

    更新日期:2009-08-01 00:00:00

  • Gasping during cardiac arrest.

    abstract:PURPOSE OF REVIEW:The purpose of this study is to review the prevalence and significance of gasping in patients experiencing cardiac arrest. RECENT FINDINGS:In a recent study by Bobrow et al., gasping was identified in 33% of patients who arrested after the arrival of emergency medical services (EMS). Patients who arr...

    journal_title:Current opinion in critical care

    pub_type: 杂志文章,评审

    doi:10.1097/MCC.0b013e3283298e00

    authors: Zuercher M,Ewy GA

    更新日期:2009-06-01 00:00:00