Medical, legal and ethical issues in critical care.

Abstract:

:This report is intended to familiarize the reader with the current legislation concerning state definitions of death, the pertinent judicial decisions concerning termination of life support and the current status of medical/ethical committees. However, it is of paramount importance to all health care personnel to become involved in the resolution of these problems. Current information regarding legal clarity to these issues leaves much to be desired. Unless we wish major decisions that will affect us all to be decided by others, it is strongly suggested that we become directly involved in this process and accept the challenge and the opportunity to influence major legal, ethical, and medical decisions.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Wallace-Barnhill G,Roth MD,Briggs BA,Bastron DR,Barrocas A

subject

Has Abstract

pub_date

1982-01-01 00:00:00

pages

57-61

issue

1

eissn

0090-3493

issn

1530-0293

journal_volume

10

pub_type

杂志文章
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    abstract:OBJECTIVE:To evaluate the prognostic value of short-latency median nerve somatosensory evoked potentials and brainstem auditory evoked potentials in outcome prediction for comatose cardiac arrest patients treated with hypothermia. DESIGN:Prospective, randomized, controlled trial of mild hypothermia after out-of-hospit...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/01.ccm.0000171536.63641.d9

    authors: Tiainen M,Kovala TT,Takkunen OS,Roine RO

    更新日期:2005-08-01 00:00:00

  • Difficulties in predicting outcome in cardiac surgery patients.

    abstract:OBJECTIVE:To evaluate a novel combination of preoperative, intraoperative, and postoperative variables (including the Parsonnet, and the Acute Physiology and Chronic Health Evaluation II and III [APACHE II and III] scores) in cardiac surgery patients in order to predict hospital outcome, complications, and length of st...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/00003246-199511000-00010

    authors: Turner JS,Morgan CJ,Thakrar B,Pepper JR

    更新日期:1995-11-01 00:00:00

  • Inflammation at the insertion site is not predictive of catheter-related bloodstream infection with short-term, noncuffed central venous catheters.

    abstract:BACKGROUND:Noncuffed, percutaneously inserted central venous catheters (CVCs) are widely used and cause at least 250,000 bloodstream infections (BSIs) in U.S. hospitals each year. We report a prospective study to determine whether inflammation at the insertion site is predictive of CVC-related BSI. METHODS:Percutaneou...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200212000-00003

    authors: Safdar N,Maki DG

    更新日期:2002-12-01 00:00:00

  • FTY720 (s)-phosphonate preserves sphingosine 1-phosphate receptor 1 expression and exhibits superior barrier protection to FTY720 in acute lung injury.

    abstract:OBJECTIVE:Effective therapies are needed to reverse the increased vascular permeability that characterizes acute inflammatory diseases such as acute lung injury. FTY720 is a pharmaceutical analog of the potent barrier-enhancing phospholipid, sphingosine 1-phosphate. Because both FTY720 and sphingosine 1-phosphate have ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000000097

    authors: Wang L,Sammani S,Moreno-Vinasco L,Letsiou E,Wang T,Camp SM,Bittman R,Garcia JG,Dudek SM

    更新日期:2014-03-01 00:00:00

  • Extracorporeal Membrane Oxygenation Use in Cardiogenic Shock: Impact of Age on In-Hospital Mortality, Length of Stay, and Costs.

    abstract:OBJECTIVES:Increasing age is a well-recognized risk factor for in-hospital mortality in patients receiving extracorporeal membrane oxygenation for cardiogenic shock, but the shape of this relationship is unknown. In addition, the impact of age on hospital length of stay, patterns of patient disposition, and costs has b...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003631

    authors: Chung M,Zhao Y,Strom JB,Shen C,Yeh RW

    更新日期:2019-03-01 00:00:00

  • Importance of the infusion rate for the plasma expanding effect of 5% albumin, 6% HES 130/0.4, 4% gelatin, and 0.9% NaCl in the septic rat.

    abstract:OBJECTIVES:To compare the plasma volume (PV) expanding effect of a fast infusion rate with that of a slow infusion rate of a fixed volume of 5% albumin, of the synthetic colloids, 6% hydroxyethyl starch 130/0.4 and 4% gelatin, and of 0.9% NaCl in a rat sepsis model and to compare the plasma-expanding effect among these...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e318274157e

    authors: Bark BP,Persson J,Grände PO

    更新日期:2013-03-01 00:00:00

  • Impaired cerebral blood flow autoregulation during posttraumatic arterial hypotension after fluid percussion brain injury is prevented by phenylephrine in female but exacerbated in male piglets by extracellular signal-related kinase mitogen-activated prot

    abstract:OBJECTIVE:Traumatic brain injury contributes to morbidity and mortality in children and boys are disproportionately represented. Hypotension is common and worsens outcome after traumatic brain injury. Extracellular signal-related kinase mitogen-activated protein kinase is upregulated and reduces cerebral blood flow aft...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181e8ac1a

    authors: Armstead WM,Kiessling JW,Kofke WA,Vavilala MS

    更新日期:2010-09-01 00:00:00

  • 1,25-Dihydroxyvitamin D fluctuations in cardiac surgery are related to age and clinical outcome*.

    abstract:OBJECTIVE:To investigate the interrelationship between cardiac surgery, age, circulating concentrations of the vitamin D hormone 1,25-dihydroxyvitamin D, and clinical outcome. DESIGN:Prospective, monocentric, two-arm parallel study. SETTING:Tertiary Heart and Diabetes Center in the Federal State of North Rhine-Westph...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1097/CCM.0b013e31824e8c42

    authors: Börgermann J,Lazouski K,Kuhn J,Dreier J,Schmidt M,Gilis-Januszewski T,Knabbe C,Gummert JF,Zittermann A

    更新日期:2012-07-01 00:00:00

  • Adverse effects of high-dose epinephrine on cerebral blood flow during experimental cardiopulmonary resuscitation.

    abstract:OBJECTIVE:To study the effects of high-dose epinephrine, compared with standard-dose epinephrine, on the dynamics of superficial cortical cerebral blood flow as well as global cerebral oxygenation during experimental cardiopulmonary resuscitation. We hypothesized that high-dose epinephrine might be unable to improve ce...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200005000-00028

    authors: Gedeborg R,Silander HC,Ronne-Engström E,Rubertsson S,Wiklund L

    更新日期:2000-05-01 00:00:00

  • Evidence based critical care medicine; what is it and what can it do for us? Evidence Based Medicine in Critical Care Group.

    abstract:OBJECTIVE:To describe the philosophy and approach to patient care called evidence based medicine, and to highlight how it can enhance the practice of intensive care. DATA SOURCES:We searched MEDLINE, reference lists, and our personal files to identify relevant literature. STUDY SELECTION:Articles on intensive care pr...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-199602000-00025

    authors: Cook DJ,Sibbald WJ,Vincent JL,Cerra FB

    更新日期:1996-02-01 00:00:00

  • Comparison of right atrial and pulmonary capillary wedge pressures.

    abstract::The right atrial pressure (Pra) was compared to the pulmonary capillary wedge pressure (Pcw) in 54 patients. In patients with heart disease, the correlation of Pra with Pcw was poor. However, in patients without clinical heart disease, Pra approximated Pcw, in both absolute number and change. This finding was independ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-197805000-00010

    authors: Risk C,Rudo N,Falltrick R,Feeley T,Don HF

    更新日期:1978-05-01 00:00:00

  • Insulin inhibits tumor necrosis factor-alpha induction in myocardial ischemia/reperfusion: role of Akt and endothelial nitric oxide synthase phosphorylation.

    abstract:OBJECTIVES:Intensive insulin therapy with tight glucose control is known to result in reduced morbidity and mortality in inflammation-related critical illness. Tumor necrosis factor (TNF)-alpha induction in myocardial infarction may trigger inflammation and have detrimental effects on cardiomyocytes. This study was des...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e3181782335

    authors: Li J,Zhang H,Wu F,Nan Y,Ma H,Guo W,Wang H,Ren J,Das UN,Gao F

    更新日期:2008-05-01 00:00:00

  • Endogenous protein C activation in patients with severe sepsis.

    abstract:OBJECTIVE:To review how endogenous protein C activation might change in disease states and to discuss the implications of these findings in the context of severe sepsis. DATA SOURCE:A review of the published literature in PubMed together with data from abstracts from 2001 to present. DATA EXTRACTION AND SYNTHESIS:Act...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.ccm.0000126125.79861.d3

    authors: Liaw PC

    更新日期:2004-05-01 00:00:00

  • Rivastigmine for the prevention of postoperative delirium in elderly patients undergoing elective cardiac surgery--a randomized controlled trial.

    abstract:OBJECTIVE:Cardiac surgery is frequently followed by postoperative delirium, which is associated with increased 1-year mortality, late cognitive deficits, and higher costs. Currently, there are no recommendations for pharmacologic prevention of postoperative delirium. Impaired cholinergic transmission is believed to pla...

    journal_title:Critical care medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/CCM.0b013e31819da780

    authors: Gamberini M,Bolliger D,Lurati Buse GA,Burkhart CS,Grapow M,Gagneux A,Filipovic M,Seeberger MD,Pargger H,Siegemund M,Carrel T,Seiler WO,Berres M,Strebel SP,Monsch AU,Steiner LA

    更新日期:2009-05-01 00:00:00

  • Surfactant protein-B polymorphisms and mortality in the acute respiratory distress syndrome.

    abstract:OBJECTIVE:To determine whether polymorphisms of the surfactant protein B gene may be associated with increased mortality in patients with the acute respiratory distress syndrome. DESIGN:A prospective cohort study. SETTING:Four adult intensive care units at a tertiary academic medical center. PATIENTS:Two hundred fou...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e318183f608

    authors: Currier PF,Gong MN,Zhai R,Pothier LJ,Boyce PD,Xu L,Yu CL,Thompson BT,Christiani DC

    更新日期:2008-09-01 00:00:00

  • Sevoflurane preconditioning improves mitochondrial function and long-term neurologic sequelae after transient cerebral ischemia: role of mitochondrial permeability transition.

    abstract:OBJECTIVE:Anesthetic preconditioning appears to be a viable strategy to treat ischemic cerebral injury. Here we investigated 1) whether the protection conferred by sevoflurane preconditioning sustains in time; 2) whether sevoflurane preconditioning diminishes mitochondrial dysfunction following cerebral ischemia; and 3...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e318258fb90

    authors: Ye R,Yang Q,Kong X,Li N,Zhang Y,Han J,Xiong L,Liu X,Zhao G

    更新日期:2012-09-01 00:00:00

  • Effects of disposable or interchangeable positive end-expiratory pressure valves on work of breathing during the application of continuous positive airway pressure.

    abstract:OBJECTIVE:To determine which of a series of disposable or interchangeable positive end-expiratory pressure (PEEP) devices functions with the least imposition of inspiratory and expiratory work during continuous positive airway pressure. DESIGN:Prospective laboratory evaluation performed on a lung model. SETTING:Resea...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199408000-00004

    authors: Kacmarek RM,Mang H,Barker N,Cycyk-Chapman MC

    更新日期:1994-08-01 00:00:00

  • Prophylactic Seizure Medication and Health-Related Quality of Life After Intracerebral Hemorrhage.

    abstract:OBJECTIVES:Prophylactic levetiracetam is currently used in ~40% of patients with intracerebral hemorrhage, and the potential impact of levetircetam on health-related quality of life is unknown. We tested the hypothesis that prophylactic levetiracetam is independently associated with differences in cognitive function he...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0000000000003272

    authors: Naidech AM,Beaumont J,Muldoon K,Liotta EM,Maas MB,Potts MB,Jahromi BS,Cella D,Prabhakaran S,Holl JL

    更新日期:2018-09-01 00:00:00

  • Sepsis and its complications: the clinical problem.

    abstract:OBJECTIVES:To review the difficulties associated with defining sepsis and its complications and to characterize the role of the proinflammatory cytokines in the development of human septic shock, adult respiratory distress syndrome, and the systemic inflammatory response syndrome. DATA SOURCES:Information presented at...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Bone RC

    更新日期:1994-07-01 00:00:00

  • Keratinocyte growth factor expression is suppressed in early acute lung injury/acute respiratory distress syndrome by smad and c-Abl pathways.

    abstract:OBJECTIVE:Keratinocyte growth factor (KGF) is expressed primarily by fibroblasts, is important for alveolar epithelial proliferation/function, and protects against lung injury in multiple animal models. We wished to determine whether acute lung injury/acute respiratory distress syndrome (ALI/ARDS) alveolar fluid induce...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/CCM.0b013e31819fc81a

    authors: Chandel NS,Budinger GR,Mutlu GM,Varga J,Synenki L,Donnelly HK,Zirk A,Eisenbart J,Jovanovic B,Jain M

    更新日期:2009-05-01 00:00:00

  • Early identification of patients at risk for symptomatic vasospasm after aneurysmal subarachnoid hemorrhage.

    abstract:OBJECTIVE:To develop a scheme for early identification of individuals at risk for symptomatic vasospasm after subarachnoid hemorrhage (SAH). DESIGN:Analysis of prospectively collected data from the placebo-treated group in a multicenter clinical trial. SETTINGS:Fifty-four neurosurgical centers in North America. MEAS...

    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00003246-200004000-00012

    authors: Qureshi AI,Sung GY,Razumovsky AY,Lane K,Straw RN,Ulatowski JA

    更新日期:2000-04-01 00:00:00

  • Critical care checklists, the Keystone Project, and the Office for Human Research Protections: a case for streamlining the approval process in quality-improvement research.

    abstract::Checklists have been recently promulgated as a method to enhance patient safety and improve outcomes for critically ill patients. Specifically, recent work performed by researchers from the Johns Hopkins Medical Institutions has demonstrated that the addition of checklists to usual care in the intensive care unit is a...

    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/CCM.0b013e31819541f8

    authors: Savel RH,Goldstein EB,Gropper MA

    更新日期:2009-02-01 00:00:00

  • The incidence of EEG abnormalities and outcome of infants paralyzed with neuromuscular blocking agents.

    abstract::The EEGs of 40 infants paralyzed with D-tubocurarine or pancuronium during the neonatal period were reviewed retrospectively. The 23 infants who survived were re-examined at 1-3 yr of age. Sixteen infants had normal or mildly abnormal EEGs in the neonatal period; 3 died of nonneurologic causes; the remainder were norm...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198312000-00004

    authors: Tharp BR,Laboyrie PM

    更新日期:1983-12-01 00:00:00

  • Randomization in clinical trials of titrated therapies: unintended consequences of using fixed treatment protocols.

    abstract:OBJECTIVE:Clinical trial designs that randomize patients to fixed treatment regimens may disrupt preexisting relationships between illness severity and level of therapy. The practice misalignments created by such designs may have unintended effects on trial results and safety. METHODS:To illustrate this problem, the T...

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    pub_type: 杂志文章

    doi:10.1097/01.CCM.0000266584.40715.A6

    authors: Deans KJ,Minneci PC,Suffredini AF,Danner RL,Hoffman WD,Ciu X,Klein HG,Schechter AN,Banks SM,Eichacker PQ,Natanson C

    更新日期:2007-06-01 00:00:00

  • Patient experiences during respirator treatment--reason for intermittent positive-pressure ventilation treatment and patient awareness in the intensive care unit.

    abstract::Patient awareness of intermittent positive-pressure ventilation (IPPV) treatment in the ICU was studied in 304 patients. These ICU patients were divided into three groups: those treated for internal medical diseases (IMD; n = 129), patients admitted after major surgical procedures (MSP; n = 126), and patients treated ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-198901000-00006

    authors: Bergbom-Engberg I,Haljamäe H

    更新日期:1989-01-01 00:00:00

  • Energy expenditure in critically ill children.

    abstract:OBJECTIVES:To measure energy expenditure in critically ill children and compare it with the energy expenditure predicted by recommended formulas, and relate the measured energy expenditure to nutritional and clinical indices. DESIGN:A prospective, clinical study. SETTING:Tertiary care pediatric intensive care unit in...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-200004000-00042

    authors: Briassoulis G,Venkataraman S,Thompson AE

    更新日期:2000-04-01 00:00:00

  • Maximum infusion rates and CVP accuracy during high-flow delivery through multilumen catheters.

    abstract::Flow rates and pressure recording accuracy were compared for Argyle 14-, 16-, and 18-ga double-lumen and Edwards 7-Fr triple-lumen CVP catheters. Physiologic saline solution was pressure-infused into dogs through one lumen and CVP was measured via the other lumen. CVP accuracy was unaltered by simultaneous rapid infus...

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    pub_type: 杂志文章

    doi:10.1097/00003246-198507000-00017

    authors: Ikeda S,Schweiss JF

    更新日期:1985-07-01 00:00:00

  • Influence of alterations in foregoing life-sustaining treatment practices on a clinical sepsis trial. The HA-1A Sepsis Study Group.

    abstract:OBJECTIVES:To evaluate the timing of foregoing life-sustaining treatments in patients enrolled in a sepsis trial and to determine their influence on patient outcome and trial results. DESIGN:Subset of patients in a prospective, randomized, double-blind, placebo-controlled study. SETTING:Twenty-three academic medical ...

    journal_title:Critical care medicine

    pub_type: 杂志文章

    doi:10.1097/00003246-199703000-00002

    authors: Sprung CL,Eidelman LA,Pizov R,Fisher CJ Jr,Ziegler EJ,Sadoff JC,Straube RC,McCloskey RV

    更新日期:1997-03-01 00:00:00

  • Impact of Gram-positive resistance on outcome of nosocomial pneumonia.

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    journal_title:Critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00003246-200104001-00005

    authors: Bodi M,Ardanuy C,Rello J

    更新日期:2001-04-01 00:00:00

  • Safety of intravenous nitroglycerin after administration of sildenafil citrate to men with coronary artery disease: a double-blind, placebo-controlled, randomized, crossover trial.

    abstract:OBJECTIVE:Although contraindicated, there are situations when a patient who has recently taken a phosphodiesterase 5 inhibitor (e.g., sildenafil) might need intravenous nitroglycerin (NTG) treatment. This study determined if, and at what dose, intravenous NTG could be administered safely to men with coronary artery dis...

    journal_title:Critical care medicine

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1097/01.CCM.0000269371.70738.30

    authors: Parker JD,Bart BA,Webb DJ,Koren MJ,Siegel RL,Wang H,Malhotra B,Jen F,Glue P

    更新日期:2007-08-01 00:00:00