Abstract:
:The image of the physician as a therapist, as well as the general perception of the physician's role in society and in the life of patients and their families, has changed dramatically in past decades. In response, many conferences, editorials, and planning activities for medical and premedical curricula have been devoted to the subject of restoring the elements of compassion and personal involvement to the relationship between physician and patient. Nonetheless, the change in the doctor-patient relationship might merely reflect the growing indifference to people as individuals that seems to pervade our society in all service-related areas. Although the loss is particularly objectionable for the sick, some may claim it is compensated by scientifically superior care in present-day medical practice. This paper will reflect briefly on past and present views of medical care and its evaluation. It will conclude that a scientifically sound evaluation of treatment might also offer a solution for restoration of human elements in the delivery of medical care.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Detre Kdoi
10.1097/00003246-198810000-00012subject
Has Abstractpub_date
1988-10-01 00:00:00pages
1002-6issue
10eissn
0090-3493issn
1530-0293journal_volume
16pub_type
传,历史文章,杂志文章abstract:OBJECTIVE:To determine a) if the admission osmole gap, the difference between osmolality and osmolarity, is the same in the neurologic-neurosurgical intensive care unit (NNICU) population as in healthy controls; b) which of 11 osmole gap formulas, or osmolality, correlates best with mannitol serum concentrations; c) wh...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000120057.04528.60
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVES:Excessive inflammation is closely related to severity and outcome of sepsis. Because interleukin-1-receptor-associated kinase 1 is a key signaling protein in the activation of NF-κB during infection, we aimed to evaluate the effect of functionally relevant haplotypes of IRAK1 on severity, development of acut...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181f9f9c7
更新日期:2010-12-01 00:00:00
abstract::Chest physiotherapy (CPT) is used frequently in the ICU, but there is little available information that quantitates its effect on cardiac or respiratory function. Nineteen mechanically ventilated patients with post-traumatic respiratory failure were studied before, immediately after, and 2 h after CPT was used to mana...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198506000-00009
更新日期:1985-06-01 00:00:00
abstract::Ventricular fibrillation (VF) can masquerade as asystole. We report a 54-yr-old male in cardiac arrest who, on surface ECG, appeared to be in VF or asystole. A bedside intracardiac recording using a transmyocardial pacing wire showed the true rhythm to be atrial fibrillation (AF) with high grade atrioventricular block...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198704000-00013
更新日期:1987-04-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of, the risk factors associated with, and the outcome of tracheostomy in a heterogeneous population of mechanically ventilated patients. DESIGN:Prospective, observational cohort study. SETTING:A total of 361 intensive care units from 12 countries. PATIENTS:A cohort of 5,081 patie...
journal_title:Critical care medicine
pub_type: 评论,杂志文章,多中心研究
doi:10.1097/01.ccm.0000150026.85210.13
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To simultaneously determine perceived vs. practiced adherence to recommended interventions for the treatment of severe sepsis or septic shock. DESIGN:One-day cross-sectional survey. SETTING:Representative sample of German intensive care units stratified by hospital size. PATIENTS:Adult patients with severe...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318186b6f3
更新日期:2008-10-01 00:00:00
abstract::The pericardium serves many important functions, but it is not essential for life. Pericardial heart disease comprises only pericarditis and its complications, tamponade and constriction, and congenital lesions. However, the pericardium is affected by virtually every category of disease. The critical care physician is...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000271159.84639.2B
更新日期:2007-08-01 00:00:00
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
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:Neutrophils are an important component of the inflammatory response that characterizes acute lung injury (ALI). This discussion aims to review the contribution of neutrophils to the development and progression of ALI and to highlight the major intracellular signaling pathways that are involved in neutrophil a...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000057843.47705.E8
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:To compare and evaluate the potential benefit of two different anticoagulation regimens during endotoxemia in an ovine model. DESIGN:Animal prospective randomized and controlled study following preliminary dose-range study conforming with the Guide for the Care and Use of Laboratory Animals as promulgated by...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200212000-00013
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of the technique of selective decontamination of the digestive tract in preventing the development of secondary infection and its influence on morbidity and mortality rates in multiple trauma patients with chest injuries requiring intermittent positive-pressure ventilation. DESIGN:Pr...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199401000-00010
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:After a stay in the intensive care unit, patients risk experiencing delusional memories, memory loss, and symptoms of posttraumatic stress. Since the 1990s, diaries have been kept for intensive care unit patients to help fill in memory gaps, aid psychosocial recovery, and improve health-related quality of lif...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0b013e31821e89c8
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:To synthesize the literature describing interventions to improve hand hygiene in ICUs, to evaluate the quality of the extant research, and to outline the type, and efficacy, of interventions described. DATA SOURCES:Systematic searches were conducted in November 2016 using five electronic databases: Medline,...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000002691
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:The objective of the study is to test whether multimodal magnetic resonance imaging can provide a reliable outcome prediction of the clinical status, focusing on consciousness at 1 year after severe traumatic brain injury (TBI). DESIGN:Single center prospective cohort with consecutive inclusions. SETTING:Cr...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31819cf050
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Neurologic dysfunction, coma, and seizures are common in obstetric patients in the intensive care unit. OBJECTIVE:To review common neurologic disorders resulting in critical illness in pregnancy. REVIEW:Obstetric disorders causing coma and seizures include eclampsia, acute fatty liver of pregnancy, and amn...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.ccm.0000182790.35728.f7
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:To determine the sensitivity, specificity, and predictive values of cultures done with blood drawn through a central venous or arterial catheter compared with peripheral venipuncture. DESIGN:Retrospective cohort study of critically ill surgical patients in whom samples for paired cultures were drawn through ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200201000-00002
更新日期:2002-01-01 00:00:00
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
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To define the epidemiology of broad-spectrum cephalosporin-resistant gram-negative bacilli in intensive care units (ICUs) during a nonoutbreak period, including the prevalence, the risk factors for colonization, the frequency of acquisition, and the rate of infection. DESIGN:Prospective cohort study. SETTIN...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199906000-00026
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the performance at admission to the pediatric intensive care unit (PICU) of five severity scores, two general (the Pediatric Risk of Mortality [PRISM] II and III scores) and three specific for meningococcal septic shock (Leclerc, Glasgow Meningococcal Septicemia Prognostic Score [GMSPS], and Gedde...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/00003246-200008000-00047
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:Evaluate clinicians' sentiments about participating in cardiac arrest resuscitations and identify factors associated with confidence in resuscitation of cardiac arrest. DESIGN:Electronic survey. SETTING:Twenty-one hospitals in Utah and Idaho. SUBJECTS:All attending physicians, residents, and nurses in a m...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003612
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVES:Optimistic expectations about prognosis by surrogate decision-makers in ICUs are common, but there are few data about the causes and clinical consequences. Our objective was to determine the causes of optimistic expectations about prognosis among surrogates and whether it is associated with more use of life ...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/CCM.0000000000003807
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To determine whether peptic activity in bronchoalveolar fluid, due to the presence of the gastric proteolytic enzyme pepsin, could serve as a biochemical marker for pulmonary aspiration of gastric contents. DESIGN:Prospective, experimental trial. SETTING:A university animal research laboratory. SUBJECTS:Th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199611000-00019
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:Intravesical pressure measurement is considered to be the gold standard for the assessment of intra-abdominal pressure. However, this method is indirect and depends on a physiologic bladder function. We evaluated a modified piezoresistive technique and a water-capsule technique for direct and continuous intra...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000198526.04530.36
更新日期:2006-03-01 00:00:00
abstract::Several variables may account for the response of electrochemical skin surface PO2 sensors to anesthetic gases: cathode material and size, pH of the electrolyte and membrane material. These variables cannot be chosen arbitrarily and their influence has been tested with two types of sensors. In one type (LSC), a large ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198110000-00010
更新日期:1981-10-01 00:00:00
abstract::We investigated clinically the differences in respiratory work of patients imposed by three modes of one ventilator: the flow-by system, the demand valve system, and the pressure support system. Inspiratory work using flow-by and pressure support systems was reduced sufficiently when compared to the demand valve syste...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199006000-00016
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the prognostic value of sublingual PCO2 (P(SL)CO2), lactate concentration, and mixed venous oxygen saturation (S(MV)O2) in hemodynamically unstable intensive care patients and, additionally, to compare the temporal changes of these variables in response to treatment....
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000054862.74829.EA
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND AND METHODS:We postulated that low-dose heparin (10 IU/kg.hr) administered as a continuous iv infusion may prevent or ameliorate the induction of thrombin-induced disseminated intravascular coagulation in baboons under general anesthesia. In a nonrandomized experiment lasting 8 hrs, animals were divided into...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199109000-00017
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVES:To address the association between the 2003 heat wave in Paris (France) and the occurrence of out-of-hospital cardiac arrest. DESIGN:: An analysis of the interventions of the medical mobile intensive care units of the City of Paris for out-of-hospital cardiac arrest and prehospital myocardial infarctions, w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181b0868f
更新日期:2009-12-01 00:00:00
abstract::The hemodynamic effects of digitalis were examined in ten patients with acute cardiac failure. Administration of 10 micrograms/kg of digoxin iv resulted in significant increases in cardiac index, stroke volume index, and left ventricular stroke work index within one hour in five patients with acute myocardial infarcti...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198711000-00002
更新日期:1987-11-01 00:00:00
abstract:OBJECTIVE:Acute renal failure remains a major challenge in critical care medicine. Both neutrophils and chemokines have been proposed as key components in the development of acute renal failure. Although the Duffy antigen receptor for chemokines (DARC) is present in several tissues and a highly specific ligand for vari...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000280570.82885.32
更新日期:2007-09-01 00:00:00