Abstract：
:In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition, the acute illness not only affects the patients but also family members or surrogates who often are overwhelmed and unable to make thoughtful decisions. In these circumstances, a time-limited trial (TLT) of intensive care treatment can be helpful. A TLT is an agreement to initiate all necessary treatments or treatments with clearly delineated limitations for a certain period of time to gain a more realistic understanding of the patient's chances of a meaningful recovery or to ascertain the patient's wishes and values. In this article, we discuss current research on different aspects of TLTs in the intensive care unit. We propose how and when to use TLTs, discuss how much time should be taken for a TLT, give an overview of the potential impact of TLTs on healthcare resources, describe ethical challenges concerning TLTs, and discuss how to evaluate a TLT.
journal_name
Intensive Care Medjournal_title
Intensive care medicineauthors
Vink EE,Azoulay E,Caplan A,Kompanje EJO,Bakker Jdoi
10.1007/s00134-018-5339-xsubject
Has Abstractpub_date
2018-09-01 00:00:00pages
1369-1377issue
9eissn
0342-4642issn
1432-1238pii
10.1007/s00134-018-5339-xjournal_volume
44pub_type
杂志文章,评审abstract：:The arterial oxygen and carbon dioxide tensions, pulmonary and systemic haemodynamics and pulmonary shunting and mechanics were measured during the first 30 min after intravenous labetalol administration. Thirty patients, recovering in the intensive care unit after neurosurgical interventions were randomly divided in ...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF00255635
更新日期：1988-01-01 00:00:00
abstract：OBJECTIVE:To investigate whether ultrasound determination of the inferior vena cava diameter (IVCD) and its collapsibility index (IVCCI) could be used to optimize the fluid removal rate while avoiding hypotension during slow continuous ultrafiltration (SCUF). METHODS:Twenty-four consecutive patients [13 men and 11 wom...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1745-4
更新日期：2010-04-01 00:00:00
abstract：OBJECTIVE:Capillary leakage syndrome (CLS) is a frequent complication in sepsis, characterized by loss of intravasal fluids leading to generalized edema and hemodynamic instability despite massive fluid therapy. In spite of its importance no standardized diagnostic criteria are available for CLS. DESIGN:Prospective cl...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340000601
更新日期：2000-09-01 00:00:00
abstract：:We present a patient with evidence of severe intravascular hemolysis after mitral valve repair, an established method for the surgical treatment of mitral valve disease to avoid prosthesis related complications. The coincidence of this uncommon complication with hemodynamic instability due to pre-existing myocardial d...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01694714
更新日期：1993-01-01 00:00:00
abstract：PURPOSE:Meconium aspiration syndrome (MAS) is a life-threatening neonatal lung injury, whose pathophysiology has been mainly studied in animal models. In such models, pancreatic secretory phospholipase A2 (sPLA2-IB) and proinflammatory cytokines present in meconium challenge the lungs, catabolising surfactant and harmi...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-011-2243-z
更新日期：2011-07-01 00:00:00
abstract：OBJECTIVE:Invasive candidiasis (IC) outcomes in intensive care units (ICUs) could be improved by the early administration of antifungals. The Candida Score (CS) prediction rule has been proposed for the selection of patients who could develop IC. Procalcitonin (PCT) levels allow prompt identification of sepsis, but the...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1623-0
更新日期：2009-12-01 00:00:00
abstract：OBJECTIVE:Definition of the changes in the activators of plasminogen, u-PA and t-PA, and examination of the possible generation of plasmin in the circulation in overwhelming sepsis. DESIGN:Serial blood analysis starting 4 h after development of symptoms of toxic shock syndrome. SETTING:Intensive care unit. PATIENT:A...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s001340050561
更新日期：1998-03-01 00:00:00
abstract：OBJECTIVE:To determine whether health-related quality of life (HRQL) in survivors of acute renal failure (ARF) occurring in intensive care is predictable from data available at the time of acute illness. DESIGN AND SETTING:Prospective pilot study in academic intensive care units. PATIENTS AND METHODS:Patients requiri...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-003-1837-5
更新日期：2003-09-01 00:00:00
abstract：OBJECTIVE:Evaluation of the distribution and antibiotic susceptibility of the aerobic gram-negative bacilli (AGNB) isolated from patients in intensive care units (ICU study). DESIGN AND SETTING:Microbiological study carried out in 1991 in 39 teaching hospitals. A standardized method was used to determine the minimum i...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01699228
更新日期：1996-10-01 00:00:00
abstract：OBJECTIVE:To validate a simple method avoiding discard volumes in pediatric patients with indwelling arterial and venous lines. DESIGN:Zero-discarding was achieved by passive extracorporeal arteriovenous backflow via standard single pressure transducer equipment. We tested backflow distances (10, 20 and 30 cm beyond t...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s001340100951
更新日期：2001-06-01 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：PURPOSE:Computerized clinical decision support systems (CDSS) for intensive insulin therapy (IIT) generate recommendations using blood glucose (BG) values manually transcribed from testing devices to computers, a potential source of error. We quantified the frequency and effect of blood glucose transcription mismatches...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-010-1868-7
更新日期：2010-09-01 00:00:00
abstract：PURPOSE:To characterize the perceived utilization of physical restraint (PR) in mechanically ventilated intensive care unit (ICU) patients and to identify clinical and structural factors influencing PR use. METHODS:A questionnaire was personally handed to one intensivist in 130 ICUs in France then collected on-site 2 ...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2715-9
更新日期：2013-01-01 00:00:00
abstract：OBJECTIVE:To describe hyperglycaemia as a possible marker of morbidity and mortality in critically ill medical and surgical patients admitted to a multidisciplinary ICU. DESIGN:Prospective cohort study. SETTING:A 13-bed non-cardiac multidisciplinary ICU in a university hospital. PATIENTS AND PARTICIPANTS:Adult patie...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-004-2325-2
更新日期：2004-08-01 00:00:00
abstract：OBJECTIVE:To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. DESIGN:Retrospective, descriptive cohort study. SETTING:10-bed burn PICU facility. PATI...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1638-6
更新日期：2009-12-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis that the rate of degradation of exogenously administered albumin is faster with bolus administration than with continuous infusion and thus that a bolus administration is less efficacious in restoring blood albumin concentration (BAC) in the hypoalbuminemic critically ill pediatric pati...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/BF01712175
更新日期：1996-05-01 00:00:00
abstract：:A randomized study of 30 patients undergoing uncomplicated surgery under spinal anesthesia was conducted to assess the influence of colloids on the kinetics of plasma fibronectin and complement. Both are opsonins of the reticuloendothelial system; moreover fibronectin is concerned with host resistance against septic c...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/BF01691428
更新日期：1991-01-01 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:Assessing pulse pressure variation (PPV) to predict fluid responsiveness in mechanically ventilated patients with tidal volume (VT) and the impact of VT and airway driving pressure (P(plat) - PEEP) on the ability of PPV for predicting fluid responsiveness. DESIGN:Prospective interventional study. SETTING:IC...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-009-1686-y
更新日期：2010-03-01 00:00:00
abstract：PURPOSE:Although low doses of oxygen (FiO2 <0.50) are considered nontoxic, recent studies have shown that even lower doses increase pulmonary inflammatory mediators. We aimed to evaluate the acute effects of reducing FiO2 on pulmonary inflammation in mechanically ventilated patients without respiratory failure. METHOD...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-012-2801-z
更新日期：2013-04-01 00:00:00
abstract：:The endothelium is a highly dynamic cell layer that is involved in a multitude of physiological functions, including the control of vascular tone, the movement of cells and nutrients, the maintenance of blood fluidity and the growth of new vessels. During severe sepsis, the endothelium becomes proadhesive, procoagulan...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/s00134-010-1893-6
更新日期：2010-08-01 00:00:00
abstract：:Intravenous bolus endotoxin elicits a marked but transient increase in plasma TxB2 and 6-keto-PGF1 alpha in a large number of species. A smaller, delayed and more prolonged increase in TxB2 and 6-keto-PGF1 alpha are reported in animals with septic shock, i.e., those with fecal peritonitis or cecal ligation. Thromboxan...
journal_title：Intensive care medicine
pub_type： 杂志文章,评审
doi：10.1007/BF00254925
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVE:Our study aimed to determine the efficacy and safety of colistin in the treatment of ventilator-associated pneumonia (VAP) caused by pan-drug-resistant Pseudomonas aeruginosa or Acinetobacter baumanii. DESIGN:Pairwise, retrospective exposed-unexposed study. SETTING:Combined medical and surgical intensive ca...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/s00134-007-0675-2
更新日期：2007-07-01 00:00:00
abstract：:Two patients with severe hepatic and renal failure underwent emergency hepatic retransplantation (2nd and 6th day after transplantation). Continuous arteriovenous haemodialysis was begun before surgery and successfully performed, without any incident, during the retransplantation with a biospal (SCU/CAVH AN 69 S) devi...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01706360
更新日期：1990-01-01 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：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：: ...
journal_title：Intensive care medicine
pub_type： 信件
doi：10.1007/s00134-018-5180-2
更新日期：2018-06-01 00:00:00
abstract：:The Editor-in-Chief has retracted this article [1] because a number of studies included in this review [2, 3, 4] (originally cited as references 98, 128, 129) have since been retracted. Consequently, this has rendered the content of the review unreliable. ...
journal_title：Intensive care medicine
pub_type： 杂志文章,撤回出版物
doi：10.1007/s00134-020-06068-5
更新日期：2020-06-01 00:00:00
abstract：OBJECTIVE:To evaluate the sensitivity, specificity and overall accuracy of a model based on the presence or absence of organ dysfunctions and/or infection (ODIN) to predict the outcome for intensive care unit patients. DESIGN:Prospective study. SETTING:General intensive care unit in a university teaching hospital. P...
journal_title：Intensive care medicine
pub_type： 杂志文章
doi：10.1007/BF01720528
更新日期：1993-01-01 00:00:00
abstract：OBJECTIVE:To investigate the relationship between cytokines and the inflammatory responses in patients with out-of-hospital cardiac arrest, we examined the changes of cytokines as well as alterations in the markers of neutrophil activation, platelet and endothelial activation, and endothelial injury. DESIGN:Prospectiv...
journal_title：Intensive care medicine
pub_type： 临床试验,杂志文章
doi：10.1007/s001340050907
更新日期：1999-06-01 00:00:00
