Abstract:
PURPOSE OF REVIEW:Professional organizations, consensus groups, and stakeholders are calling for better palliative care in acute care settings, particularly in ICUs. Our ability to deliver that care is dependent on the outcomes associated with palliative care in the ICU. This review provides a conceptual framework for these outcomes, discusses current and future challenges for work in this field, and advocates for better use of patient-centered outcomes in future studies. RECENT FINDINGS:Previous studies of palliative care interventions in the ICU have used heterogeneous outcomes, conceptualized as: systems-related, content-related, clinician-related, or patient/family-related. Few outcomes were used in multiple studies and many studies had insufficient power and questionable generalizability and impact. Although nearly all previous studies incorporated family-related outcomes, not one incorporated patient-centered outcomes, such as health-related quality of life, patient symptom score, or consensus between patient goals and care provided. SUMMARY:Delivery of palliative care in the ICU will be hampered until studies incorporate outcomes that are: responsive to and reflective of variations in care, and multi-faceted (with patient-centered components) to reflect the multi-dimensional nature of palliative care and the varied needs of different stakeholders.
journal_name
Curr Opin Crit Carejournal_title
Current opinion in critical careauthors
Aslakson RA,Bridges JFdoi
10.1097/MCC.0b013e328364d50fsubject
Has Abstractpub_date
2013-10-01 00:00:00pages
504-10issue
5eissn
1070-5295issn
1531-7072journal_volume
19pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:To describe the current knowledge about clinical and microbiological diagnosis of nonventilated hospital-acquired pneumonia (NV-HAP). RECENT FINDINGS:NV-HAP is emerging as a new challenge for clinicians, particularly because VAP incidence has been decreasing. The clinical diagnosis of NV-HAP uses the...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000525
更新日期:2018-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Delayed awakening after targeted temperature management (TTM) and sedation is frequent among cardiac arrest patients. Differentiating between prolonged coma and irreversible cerebral damage can be challenging, therefore the utilization of a multimodal approach is recommended by international guideline...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000406
更新日期:2017-06-01 00:00:00
abstract:PURPOSE OF REVIEW:Status epilepticus is a neurological emergency associated with high morbidity and mortality. There is a lack of robust data to guide the management of this neurological emergency beyond the initial treatment. This review examines recent literature on treatment considerations including the choice of co...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000661
更新日期:2019-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Selenium is a trace element essential to human health. Critical illness is associated with the generation of oxygen free radicals resulting in a condition of oxidative stress. Supplementing critically ill patients with antioxidant nutrients may improve survival. Selenium levels can be low due to redis...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/01.ccx.0000216581.80051.d6
更新日期:2006-04-01 00:00:00
abstract:PURPOSE OF REVIEW:The present article reviews the recent literature on the main aspects of perioperative acute kidney injury (AKI). RECENT FINDINGS:AKI occurs in 1 in every 10 surgical patients, with cardiac, orthopedic, and major abdominal surgeries being the procedures associated with the highest risk. Overall, comp...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000560
更新日期:2018-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Multimodal monitoring has emerged as a novel paradigm of care in acute brain injury, and in this context the value of noninvasive devices is increasingly under scrutiny. This narrative review summarizes recent clinical investigation focused on the role of automated infrared pupillometry (AIP) and opti...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000710
更新日期:2020-04-01 00:00:00
abstract::Increased knowledge of the mechanisms that determine respiratory failure has led to the development of new technologies aimed at improving ventilatory treatment. Proportional assist ventilation and neurally adjusted ventilatory assist have been designed with the goal of improving patient-ventilator interaction by matc...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200302000-00010
更新日期:2003-02-01 00:00:00
abstract::Critical illness polyneuropathy (CIP) is a syndrome that was first extensively described in the early 1980s, mainly in patients with failure to wean from mechanical ventilation. The syndrome is further characterized by limb muscle weakness, usually more pronounced distally than proximally, and is often accompanied by ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200208000-00006
更新日期:2002-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite decades of advances in prehospital and in-hospital medical care, patients with out-of-hospital cardiac arrest continue to have poor neurologic and cardiac function following otherwise successful resuscitation. This review examines the mechanisms and therapeutic strategies currently under devel...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000087
更新日期:2014-06-01 00:00:00
abstract:PURPOSE OF REVIEW:When classic examinations such as bronchoalveolar lavage are not contributory in the etiologic diagnosis of unresolving acute respiratory distress syndrome, surgical lung biopsy would appear to be useful to determine the specific cause, particularly infection or postaggressive fibrosis, which could be...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e3282f33e42
更新日期:2008-02-01 00:00:00
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
更新日期:2002-10-01 00:00:00
abstract::Clinicians are increasingly aware that fungal pathogens are a significant cause of morbidity and mortality in hospitalized patients. Historically, these infections occurred in severely immunocompromised patients who were undergoing treatment for hematological malignancy or solid organ transplantation. Currently, howev...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200108000-00005
更新日期:2001-08-01 00:00:00
abstract:PURPOSE OF REVIEW:Status epilepticus has a high morbidity and mortality. There are little definitive data to guide management; however, new recent data continue to improve understanding of management options of status epilepticus. This review examines recent advancements regarding the critical care management of status...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000392
更新日期:2017-04-01 00:00:00
abstract:PURPOSE OF REVIEW:In the 1980s, we witnessed tremendous advances in trauma care including trauma system development, advanced trauma life support, damage control surgery and ICU resuscitation. As a result, patients who used to bleed to death in the operating room survived. However, many went on to develop multiple orga...
journal_title:Current opinion in critical care
pub_type: 社论
doi:10.1097/MCC.0b013e3283409d16
更新日期:2010-12-01 00:00:00
abstract:PURPOSE OF REVIEW:To describe and put into context recent conceptual advances regarding the relationship of energy load and power to ventilator-induced lung injury (VILI). RECENT FINDINGS:Investigative emphasis regarding VILI has almost exclusively centered on the static characteristics of the individual tidal cycle -...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000470
更新日期:2018-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Antimicrobials are very commonly used drugs in the intensive care setting. Extensive research has been conducted in recent years to describe their pharmacokinetics/pharmacodynamics in order to maximize the pharmacological benefit and patient outcome. Translating these new findings into clinical practi...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000229
更新日期:2015-10-01 00:00:00
abstract::Reactive oxygen species are reactive, partially reduced derivatives of molecular oxygen (O 2 ). Important reactive oxygen species in biologic systems include superoxide radical anion, hydrogen peroxide, and hydroxyl radical. Closely related species include the hypohalous acids, particularly hypochlorous acid; chlorami...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200202000-00002
更新日期:2002-02-01 00:00:00
abstract:PURPOSE OF REVIEW:Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early rehabilitation of ICU patients has recently been identified as an important focus for interdisciplinary ICU teams. However, the amount of rehabilitation...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328357f022
更新日期:2012-10-01 00:00:00
abstract:PURPOSE OF REVIEW:To examine recent developments in preventing and treating postoperative acute renal dysfunction. To review contemporary issues concerning perioperative fluid and electrolyte management. RECENT FINDINGS:Renal dysfunction remains a major postoperative morbidity despite the advent of intermittent and co...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328348bef5
更新日期:2011-08-01 00:00:00
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
更新日期:2003-06-01 00:00:00
abstract:PURPOSE OF REVIEW:There is growing evidence that bone health is impacted during and after critical illness in multiple ways. In this review, we provide a practical update on postcritical care bone loss with an insight on identification of persons at risk, prevention and treatment strategies. RECENT FINDINGS:Critical i...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000734
更新日期:2020-08-01 00:00:00
abstract:PURPOSE OF REVIEW:This article reviews the current literature dealing with pathophysiology, diagnostics, bleeding management, and thromboprophylaxis in patients with acute and chronic liver dysfunction. RECENT FINDINGS:Routine coagulation tests such as prothrombin time and International Normalized Ratio (INR) are not ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e32835ebb52
更新日期:2013-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Fever is common in the ICU among patients with severe brain injury. Fever has been consistently shown to exacerbate brain injuries in animal models and has been consistently associated with poor outcome in human studies. However, whether fever control improves outcome and the ideal means of fever cont...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000070
更新日期:2014-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Cardiac arrest is one of the most challenging disease processes to study with clinical trials due to the emergent and unpredictable nature of these events and complexity of the patient population. In recent years, there has been a major push to complete more large, multicentre trials. In many cases, h...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000765
更新日期:2020-12-01 00:00:00
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
更新日期:2014-10-01 00:00:00
abstract:PURPOSE OF REVIEW:Acute respiratory distress syndrome (ARDS) is a multifaceted lung disease with no current effective therapy. Many clinical trials using conventional pharmacologic therapies have failed, suggesting the need to examine alternative approaches. Thus, attention has focused on the therapeutic potential of c...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000061
更新日期:2014-02-01 00:00:00
abstract:PURPOSE OF REVIEW:End-of-life care and communication deficits are important sources of conflicts within ICU teams and with patients or families. This narrative review describes recent studies on how to improve palliative care and surrogate decision-making in ICUs and compares the results with previously published liter...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0b013e328358d417
更新日期:2012-12-01 00:00:00
abstract::Radiocontrast nephropathy may in part be mediated by generation of reactive oxygen species causing direct toxic damage to renal tubular epithelial cell and renal medullary ischemia. Data from experimental studies indicated that antioxidants, eg, acetylcysteine, may prevent radiocontrast-induced nephropathy. Recently, ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200112000-00004
更新日期:2001-12-01 00:00:00
abstract:PURPOSE OF REVIEW:The present article will review the current state of our understanding of nephrotoxic medication-associated acute kidney injury (AKI) and provide strategies to reduce its impact. RECENT FINDINGS:Nephrotoxic medications contribute to a substantial proportion of AKI in hospitalized patients. The previo...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/MCC.0000000000000355
更新日期:2016-12-01 00:00:00
abstract::The care of critically ill patients and the advent of the modern day intensive care unit (ICU) present a large person power and cost burden to society. The high cost of critical care is attributed to high overhead expenses (eg, experienced staff and equipment), high resource utilization (eg, pharmaceutical resources, ...
journal_title:Current opinion in critical care
pub_type: 杂志文章,评审
doi:10.1097/00075198-200108000-00015
更新日期:2001-08-01 00:00:00