Abstract:
BACKGROUND:As evidence exist that severe neurological damage or prolonged death after inappropriate CPR could occur, restraints and indications for CPR were perceived as necessary. The objective of this review is to examine policies and attitudes towards end-of-life decisions in Europe and North America and to outline differences and similarities. METHODS:A bibliographic database search from 1990 to 2006 was performed using the following terms: do-not-resuscitate orders, end-of-life decisions, withholding/withdrawal of life-sustaining treatments, medical futility and advanced directives. Eighty-eight articles, out of 305 examined, were analyzed and their data systematically reported and compared where possible. They consisted of studies, questionnaires and surveys answering the following questions: percentage of deaths of critical patients preceded by do-not-resuscitate orders, factors affecting the decision for do-not-resuscitate orders, people involved in this decision (patient, surrogates and medical staff) and how it was performed. RESULTS:There is an evident gap between the North American use of standard and formal procedures compared with Europe. Second, they diverge in the role acknowledged to surrogates in the decisional process, as in Europe, restraints and reserves to accept surrogates as decision makers seem still strong and a paternalistic approach at the end-of-life is still present. CONCLUSION:Incidentally, despite the predictable differences between Europe and North America, concerns do exist about the actual extent of autonomy wished by patients and surrogates. It is important to highlight these findings, as the paternalistic attitude, too often negatively depicted, could be, according to the best medical practice, justified and more welcomed in some instances.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Moselli NM,Debernardi F,Piovano Fdoi
10.1111/j.1399-6576.2006.01150.xsubject
Has Abstractpub_date
2006-11-01 00:00:00pages
1177-86issue
10eissn
0001-5172issn
1399-6576pii
AAS1150journal_volume
50pub_type
杂志文章,评审abstract:BACKGROUND:Intermittent pneumatic foot compression (IPC) is a useful technique for prophylaxis of peri-operative venous thromboembolism. The aim of this study was to determine the effect of IPC on blood coagulation/fibrinolysis and platelet function using a blood viscometer (Sonoclot) and a platelet aggregation monitor...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-6576.2005.00661.x
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Since the cuffed oropharyngeal airway (COPA) has been suggested to cause less pharyngeal trauma than the laryngeal mask airway (LMA), we conducted a prospective, randomised study to compare haemodynamic changes after placing either the COPA or LMA in healthy anaesthetised adults. METHODS:After standard mida...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.1999.431014.x
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Increase in day surgery has challenged preoperative anaesthesia with need to identify a few high-risk patients requiring detailed preoperative intervention. We aimed to assess if a nurse-administered Preoperative Patient-centred Anaesthesia System (Pre-PAS) could identify high-risk patients, defined as ASA s...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13678
更新日期:2020-11-01 00:00:00
abstract::Differential lung ventilation to achieve optimised ventilation for each lung is a procedure rarely used in the intensive care unit, to treat select cases of severe unilateral lung disease in intensive care. However, existing techniques both for securing the airway and ventilating the lungs are challenging and have com...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12285
更新日期:2014-04-01 00:00:00
abstract::In a double-blind study, 57 patients were anaesthetized with either Althesin, thiopentone, or fentanyl combined with diazepam for cystoscopies. One and a half and four hours after the administration of anaesthesia, the patients were investigated with an objective neuropsychological method, continuous Reaction Time, an...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-6576.1982.tb01744.x
更新日期:1982-04-01 00:00:00
abstract::The effect of intravenous procaine, 2 mg/kg/min, on the cardiovascular function of nine patients scheduled for cardiac valve replacement was studied under enflurane-pancuronium anaesthesia. Procaine infusion was started after intubation during steady-state anaesthesia, and continued until start of cardiopulmonary by-p...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1984.tb02005.x
更新日期:1984-02-01 00:00:00
abstract::In vitro tests for the diagnosis of malignant hyperthermia susceptibility were performed in 105 patients and 20 normal controls according to the protocol of the European MH Group. Results of dynamic halothane and caffeine tests (in which muscle bundle length is cyclically changed) were compared to those of static test...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1987.tb02603.x
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:The question whether some opioids exert less respiratory depression than others has not been answered conclusively. We applied pharmacokinetic/pharmacodynamic (PKPD) modeling to obtain an estimate of the C50 for the depression of CO2 elimination as a measure of the respiratory depressant potency of alfentani...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1046/j.1399-6576.2003.00251.x
更新日期:2003-11-01 00:00:00
abstract::The potency and speed of onset of fazadinium and d-tubocurarine have been compared at three cumulative doses. Wtih thiopentone as the induction agent, the dose ratio fazadinium/d-tubocurarine ranged from 1.2 to 1.3 for single twitch reduction and from 1.1 to 1.2 for reduction of tetanus. The times taken for the develo...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1979.tb01459.x
更新日期:1979-08-01 00:00:00
abstract::Regional anaesthesia has many advantages over general anaesthesia in hip surgery. When the effects of total hip replacement under spinal or general anaesthesia were compared in 22 patients, the only difference between the groups occurred in PHA-induced lymphocyte proliferative responses. In contrast, no differences be...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1990.tb03078.x
更新日期:1990-04-01 00:00:00
abstract::A previously healthy woman (20 years old) was admitted to our hospital with several fractures after a car accident. She was sedated with propofol, etc. in doses ranging from 1.4 to 5.1 mg/kg/h for 88 h. She developed multiple organ failure with rhabdomyolysis and died. This case fulfils (except acidosis) the criteria ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.00904.x
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Several methods may enhance the inhalational induction of anesthesia. In this randomized double-blind study, we evaluated the speed of induction of anesthesia with sevoflurane with or without pre-oxygenation. METHODS:Fifty-four patients scheduled for hysteroscopy received for 10 min air or 100% oxygen via a...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2006.00981.x
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Gas exchange during high-frequency jet ventilation (HFJV) for prolonged rigid bronchoscopy (RBS) is usually monitored by arterial blood gas analysis. Capnography of expired gases during brief HFJV discontinuation may be a reliable and noninvasive supplemental method. Capnography can be performed either for s...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2000.440406.x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Hydroxyethyl starches (HES) have been shown to decrease clot strength and to increase coagulation times assessed by thromboelastography (TEG). HES with minimal anticoagulant side-effects is beneficial for plasma volume expansion in the perioperative setting. A comparison of the in vivo effects of high, middl...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.2003.470112.x
更新日期:2003-01-01 00:00:00
abstract::The haemodynamic effects of morphine (2.5 mg kg-1) and fentanyl (16.7 and 25 micrograms kg-1) were compared in patients undergoing coronary artery bypass surgery. Morphine or fentanyl in combination with pancuronium, nitrous oxide and a small dose of thiopentone produced some deterioration of myocardial performance. B...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1983.tb01919.x
更新日期:1983-04-01 00:00:00
abstract::The purpose of this study was to compare the frequency of psychomimetic reactions after 24 h and 3 months following total intravenous anaesthesia with propofol and neurolept anaesthesia. Forty otherwise healthy female patients were randomly divided into two groups. All were undergoing elective gynaecological laparotom...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1993.tb03593.x
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Pressure measuring systems using fluid-filled catheters can result in the recording of distorted pressure waveforms. It results in phase delay, overestimation of systolic and, to a lesser extent, of diastolic pressure. We designed and evaluated a method to correct this pressure waveform distortion using an a...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1998.tb05307.x
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Short-term infusion of atrial natriuretic peptide (ANP) increases renal blood flow (RBF) and glomerular filtration rate (GFR) in patients with acute renal dysfunction. In the present study we evaluated the effects of long-term infusion (>48 h) of ANP on (RBF) and (GFR) in 11 postcardiac surgical patients req...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1034/j.1399-6576.2001.045005536.x
更新日期:2001-05-01 00:00:00
abstract::Bambuterol is a new bronchodilator which is also a reversible inhibitor of plasma cholinesterase. In patients with normal plasma cholinesterase genotype, bambuterol prolongs suxamethonium-induced neuromuscular blockade. In the present study, we investigated the interaction of bambuterol and suxamethonium in nine patie...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1990.tb03153.x
更新日期:1990-10-01 00:00:00
abstract::A 42-year-old patient had undergone total hip replacement for aseptic femoral head necrosis 9 years previously. He now presented with loosening of the prosthesis and pseudoarthrosis sustained following a femoral shaft fracture 7 months earlier. A total hip replacement was carried out in general anaesthesia combined wi...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1990.tb03064.x
更新日期:1990-02-01 00:00:00
abstract::Adenosine, an endogenous compound with a known antinociceptive effect when administered into the CNS, was applied in nine patients (21-65 years) by the peripheral intravenous route (70-130 micrograms.kg-1.min-1) as a replacement for peroperative opioids during inhalation anaesthesia for surgical procedures not requiri...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1992.tb03526.x
更新日期:1992-08-01 00:00:00
abstract:INTRODUCTION:The aim of the present multicentre study is to assess health-related quality of life in patients with community-acquired sepsis, severe sepsis, or septic shock (CAS) 6 months after discharge from the intensive care unit (ICU) and to compare the health-related quality of life of the ICU survivors with CAS w...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,多中心研究
doi:10.1111/aas.12164
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Intermittent boluses for neural blockade provide better post-operative analgesia when compared to continuous infusion. However, these techniques of administration have not yet been compared while performing adductor canal block (ACB). We compared intermittent vs. continuous ACB for managing po...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/aas.12787
更新日期:2016-11-01 00:00:00
abstract::Application of self-administered postoperative prophylactic positive expiratory pressure (S-PEP) treatment in addition to conventional physiotherapy was investigated in 75 patients undergoing thoracotomy. Twenty-nine patients used a face-mask set supplied with an expiratory resistance (S-PEP group) and 27 patients use...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1986.tb02435.x
更新日期:1986-07-01 00:00:00
abstract::Heat loss during anesthesia and operation and subsequent hypothermia will increase the postoperative oxygen demand and may endanger patients with restricted cardiopulmonary reserves. Forty patients scheduled for intra-abdominal aortic surgery and 40 patients scheduled for peripheral vascular surgery on the lower limbs...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1984.tb02109.x
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:Impairment of surfactant is involved in development of acute respiratory distress syndrome. To develop artificial surfactant substitute for clinical use, we prepared synthetically reconstituted surfactant (SRS) by adding porcine surfactant-associated protein B and C (SP-B and SP-C) to synthetic phospholipids...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.1999.430807.x
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Off-pump coronary artery bypass grafting (OPCAB) can be associated with severe cardiovascular changes, thus requiring advanced haemodynamic monitoring. Our aim was to investigate the feasibility of transpulmonary single thermodilution (STD) combined with pulse-contour analysis, a newly introduced method for ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2006.01247.x
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Pain after coronary artery bypass surgery persists for several days. A continuous intravenous infusion of an opioid adequately accomplishes good pain control in the intensive care unit, but it is often not suitable on the ordinary ward. Patient-controlled analgesia (PCA) with intermittent injections delivere...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.2000.440108.x
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:It has been shown that when cardiac output (CO) decreases during continuous positive pressure ventilation (CPPV), its regional distribution adapts with a favouring of vital organs. Does epidural blockade modify this adaptation? METHODS:Regional blood flows were assessed by the microsphere technique (15 micr...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2001.450115.x
更新日期:2001-01-01 00:00:00
abstract::Non-steroidal anti-inflammatory drugs (NSAID) effectively reduce the need for opioid analgesia after various types of surgery. The efficacy of diclofenac and ketoprofen to relieve pain after maxillofacial surgery was compared in the present study. In a randomized and double-blind fashion, 90 ASA I-II patients (16-60 y...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1995.tb05599.x
更新日期:1995-01-01 00:00:00