Abstract:
OBJECTIVE:To determine the influence of religious affiliation and culture on end-of-life decisions in European intensive care units (ICUs). DESIGN AND SETTING:A prospective, observational study of European ICUs was performed on consecutive patients with any limitation of therapy. Prospectively defined end-of-life practices in 37 ICUs in 17 European countries studied from 1 January 1999 to 30 June 2000 were compared for frequencies, patterns, timing, and communication by religious affiliation of physicians and patients and regions. RESULTS:Of the 31,417 patients 3,086 had limitations. Withholding occurred more often than withdrawing if the physician was Jewish (81%), Greek Orthodox (78%), or Moslem (63%). Withdrawing occurred more often for physicians who were Catholic (53%), Protestant (49%), or had no religious affiliation (47%). End-of-life decisions differed for physicians between regions and who had any religious affiliation vs. no religious affiliation in all three geographical regions. Median time from ICU admission to first limitation of therapy was 3.2 days but varied by religious affiliation; from 1.6 days for Protestant to 7.6 days for Greek Orthodox physicians. Median times from limitations to death also varied by physician's religious affiliation. Decisions were discussed with the families more often if the physician was Protestant (80%), Catholic (70%), had no religious affiliation (66%) or was Jewish (63%). CONCLUSIONS:Significant differences associated with religious affiliation and culture were observed for the type of end of life decision, the times to therapy limitation and death, and discussion of decisions with patient families.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Sprung CL,Maia P,Bulow HH,Ricou B,Armaganidis A,Baras M,Wennberg E,Reinhart K,Cohen SL,Fries DR,Nakos G,Thijs LG,Ethicus Study Group.doi
10.1007/s00134-007-0693-0subject
Has Abstractpub_date
2007-10-01 00:00:00pages
1732-9issue
10eissn
0342-4642issn
1432-1238journal_volume
33pub_type
杂志文章,多中心研究abstract:PURPOSE:To determine the oxygen affinity for optimal tissue oxygen delivery with a hemoglobin-hydroxyethyl starch conjugate (HRC 101). METHODS:Anesthetized rats were hemodiluted (180 ml kg(-1)) with low (P(50) approximately 70 mmHg) or high affinity (P(50) approximately 14 mmHg) HRC 101 at hemoglobin (Hb) concentratio...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-009-1532-2
更新日期:2009-11-01 00:00:00
abstract::The effect of enteral feeding on O2-consumption (VO2) and CO2-production (VCO2) was studied in 9 ventilator-dependent patients, who were in a stable condition without signs of hypermetabolism. Resting energy expenditure (REE) in postabsorptive state was assessed and enteral feeding was started by continuous drip (480 ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00717989
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To report the feasibility of craniectomy with duraplasty in four patients with life-threatening encephalitis and, in particular, their long-term outcome. DESIGN:Report of four cases, analysis of the acute clinical course and neurological long-term sequelae. RESULTS:Generous craniectomy with duraplasty was p...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340101027
更新日期:2001-08-01 00:00:00
abstract::The increase of the inflationary lung volume created by a respiratory maneuver is critical for preventing postoperative alveolar collapse. We measured this volume as achieved with IPPB or incentive spirometry (IS) in 20 postoperative surgical patients. Using IPPB, with gas flow and peak airway pressures carefully adju...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01641120
更新日期:1977-12-01 00:00:00
abstract:OBJECTIVE:To examine whether an appropriately designed combination of an index of ventilatory endurance and the frequency divided by tidal volume ratio (f/VT) provides prognostic information for weaning outcome not offered by any index alone. DESIGN AND SETTING:Prospective study in a multidisciplinary intensive care u...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0104-y
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of traditional and online teaching methods for educating anesthesiology residents in the principles and practice of difficult airway management. DESIGN:Prospective, randomized, controlled trial. SETTING:University hospital. PARTICIPANTS:Two randomly selected groups, each contai...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-005-2561-0
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:A case-control comparison of Doppler guidance on the success rate of central venous cannulation in patients with normal or reduced intracranial compliance. DESIGN:A single operator performed central venous access procedures with continuous wave Doppler guidance. It was used on patients on a ventilator. The p...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1007/s00134-003-1862-4
更新日期:2003-09-01 00:00:00
abstract::As a result of the previous shortage of tools to assess objectively the overall physiological status of the respiratory system in infants and young children, it has been difficult to measure the degree of physiological disorder or the response to therapy in respiratory diseases such as BPD, the pediatric version of AR...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/BF01704742
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:To assess the ability of the Clinical Risk Index for Babies (CRIB) to predict long-term neurodevelopmental impairment in very low birth weight (VLBW) infants. DESIGN:Single-center cohort study. SETTING:Tertiary neonatal care hospital and follow-up clinic. PATIENTS:Four hundred fifty-five VLBW infants conse...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051157
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVES:To establish a preliminary list of critical incidents (CIs) associated with mechanical ventilation and to describe a CI reporting method. DESIGN:A list of CIs was established based on a consensus among ICU caregivers. The list was compared to CIs collected prospectively during a predefined study period. SE...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-002-1251-4
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To investigate ventilation-perfusion (VA/Q) relationships, during continuous axial rotation and in the supine position, in patients with acute lung injury (ALI) using the multiple inert gas elimination technique. DESIGN:Prospective investigation. SETTING:Eighteen-bed intensive care unit in a university hosp...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340050534
更新日期:1998-02-01 00:00:00
abstract::During the last two decades, severe group A beta-haemolytic streptococcal infections have been defined as the "toxic strep syndrome", and have been reported not only in immunocompromised or elderly people, but also occasionally in previously healthy patients. We describe 4 patients presenting with the toxic strep synd...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01709279
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To report the first case of ARDS in children treated with nitric oxide (NO) inhalation. METHODS:A 13-months infant presented with BPD and severe hypoxemia related to RSV infection and ARDS. Inhaled NO was delivered in the ventilatory circuit of a continuous flow ventilator (Babylog 8000, Dräger) in a concent...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01711907
更新日期:1994-08-01 00:00:00
abstract::Placement of a Swan-Ganz catheter can cause many complications. This case report presents a new complication of Swan-Ganz catheter insertion--placement of the Swan-Ganz catheter tip in the coronary sinus. ...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00254707
更新日期:1987-01-01 00:00:00
abstract:INTRODUCTION:Most anxiolytics and sedative regimens in the intensive care unit (ICU) impair intellectual function, reducing patient autonomy, and often add to patient morbidity. Using an ICU-validated cognitive assessment tool Adapted Cognitive Exam (ACE), we performed a comparison between dexmedetomidine (DEX) and pro...
journal_title:Intensive care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s00134-010-1874-9
更新日期:2010-09-01 00:00:00
abstract::The purpose of this study was noninvasive assessment of respiratory compliance and resistance in mechanically ventilated patients with acute respiratory failure (ARF). To this end, flow, change in lung volume, and airway pressure were measured at the proximal tip of the endotracheal tubes in twenty nine critically ill...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00263528
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:Do-not-resuscitate orders (DNR orders) and advance directives (AD) have been developed and their use by patients is increasing. The objective of the study was to evaluate the compliance with patient's wishes and doctors' and nurses' agreement on decision-making in the treatment of elderly patients from a cros...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340000602
更新日期:2000-09-01 00:00:00
abstract::The influence of varying cardiac output (CO) on thermal-dye extravascular lung water (EVLW) was investigated in a total of 40 cardiac surgery patients before the onset of the operation. EVLW was measured by means of the double indicator dilution technique with indocyanine green as the non-diffusible indicator and a mi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00255785
更新日期:1987-01-01 00:00:00
abstract::In oleic acid-induced pulmonary oedema (OAPO) sequential intrapulmonary fluid accumulation occurs leading to different expiratory flow pattern in dependent lung regions. The potential effects on efficacy of high-frequency jet ventilation (HFJV, f = 3 Hz, I: E = 0.43, FiO2 = 0.4) were studied and compared with continuo...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF00295986
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the physiological effects of decannulation on breathing patterns and respiratory mechanics by comparing mouth breathing (MB) to tracheal breathing (TB) in tracheostomized patients. DESIGN AND SETTING:Prospective cross-over study in a critical and neuromuscular care unit. PATIENTS AND METHODS:Nin...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-002-1545-6
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Candidemia is a life-threatening infection in the ICU whose prognosis is highly dependent on the stage at which it is recognized. Procalcitonin (PCT) levels have been shown to accurately distinguish between bacteremia and noninfectious inflammatory states in critically ill patients with clinical signs of sep...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-006-0306-3
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To assess the value of the diagnosis of overt disseminated intravascular coagulation (DIC) according to the International Society on Thrombosis and Haemostasis (ISTH) criteria and that of the parameters included in the ISTH score for overt DIC in predicting day 28 mortality in intensive care patients. Also, t...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-005-2685-2
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of early transcranial Doppler ultrasound (TCD) goal-directed therapy after severe traumatic brain injury initiated before invasive cerebral monitoring is available. DESIGN:Prospective, observational clinical study. SETTING:Surgical intensive care unit, university hospital. PATIEN...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-007-0558-6
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:Five commercially available oesophageal balloon catheters (OBCs) were tested to evaluate the accuracy in transmitting fast-changing pressure signals which can be observed, for example, during phrenic nerve stimulation. SETTING:Research laboratory of a university hospital. METHOD:The OBCs tested varied in le...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s001340051182
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:To determine the magnitude and time course of adrenergic effects on metabolism in volunteers and possible implications for the use of sympathomimetics in the critically ill. DESIGN:Descriptive laboratory investigation. SUBJECTS:7 volunteers. INTERVENTION:Primed continuous infusions of stable isotope tracer...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/BF01707665
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:There are a number of potential etiologies of severe bleeding encountered in the intensive care unit. Although rare, acquired hemophilia is one such etiology that often presents with major bleeding requiring intensive care. Despite the introduction of effective treatments, the reported mortality rate of patie...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-011-2258-5
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:The efficacy of noninvasive continuous positive airway pressure (CPAP) to improve outcomes in severe hypoxemic acute respiratory failure (hARF) due to pneumonia has not been clearly established. The aim of this study was to compare CPAP vs. oxygen therapy to reduce the risk of meeting criteria for endotracheal ...
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/s00134-014-3325-5
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:It remains uncertain why immunocompetent patients with bacterial community-acquired pneumonia (CAP) die, in spite of adequate antibiotics. METHODS:This is a secondary analysis of the CAPUCI database which was a prospective observational multicentre study. Two hundred and twelve immunocompetent patients admi...
journal_title:Intensive care medicine
pub_type: 杂志文章
doi:10.1007/s00134-008-1363-6
更新日期:2009-03-01 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:OBJECTIVE:To describe the clinical course of quinine-induced disseminated intravascular coagulation (DIC) and review all previous cases reported in the medical literature. DESIGN:Case report/literature review. SETTING:University teaching hospital medical ICU. PATIENTS:One patient in whom thrombocytopenia, coagulopat...
journal_title:Intensive care medicine
pub_type: 杂志文章,评审
doi:10.1007/s00134-003-1732-0
更新日期:2003-06-01 00:00:00