Abstract：
:Controlled donation after circulatory determination of death (cDCDD) concerns donation after withdrawal of life-sustaining therapy (W-LST). We examine the ethical issues raised by W-LST in the cDCDD context in the light of a review of cDCDD protocols and the ethical literature. Our analysis confirms that W-LST procedures vary considerably among cDCDD centers and that despite existing recommendations, the conflict of interest in the W-LST decision and process might be difficult to avoid, the process of W-LST might interfere with usual end-of-life care, and there is a risk of hastening death. In order to ensure that the practice of W-LST meets already well-established ethical recommendations, we suggest that W-LST should be managed in the ICU by an ICU physician who has been part of the W-LST decision. Recommending extubation for W-LST, when this is not necessarily the preferred procedure, is inconsistent with the recommendation to follow usual W-LST protocol. As the risk of conflicts of interest in the decision of W-LST and in the process of W-LST exists, this should be acknowledged and disclosed. Finally, when cDCDD programs interfere with W-LST and end-of-life care, this should be transparently disclosed to the family, and specific informed consent is necessary.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Dalle Ave AL,Shaw DMdoi
10.1177/0885066615625628subject
Has Abstractpub_date
2017-03-01 00:00:00pages
179-186issue
3eissn
0885-0666issn
1525-1489pii
0885066615625628journal_volume
32pub_type
杂志文章,评审abstract：:Intracerebral hemorrhage (ICH) in patients with oral anticoagulation therapy is an increasingly prevalent problem in large part due to the aging population and the increased use of anticoagulants for patients at high risk of thrombosis. Warfarin has been virtually the only outpatient anticoagulant choice until fairly ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066613488732
更新日期：2015-02-01 00:00:00
abstract：:Patients admitted to the cardiac intensive care unit (CICU) are often in shock and require hemodynamic support. Identifying and addressing the pathophysiology mechanisms operating in an individual patient is crucial to achieving a successful outcome, while initiating circulatory support therapy to restore adequate tis...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620917630
更新日期：2020-04-13 00:00:00
abstract：BACKGROUND AND OBJECTIVES:The efficacy of routinely obtained chest radiographs (CXRs) on admission to the intensive care unit (ICU) is largely unknown. The current study investigated the efficacy of routinely obtained admission CXRs and determined whether the value of this diagnostic test was dependent on patient categ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066610366925
更新日期：2010-07-01 00:00:00
abstract：BACKGROUND:Lactate clearance has become important in the management of sepsis. However, factors unrelated to sepsis-induced hyperlactatemia, including β-2 adrenergic agonists, can interfere with lactate clearance. OBJECTIVES:To investigate the association of inhaled albuterol with lactate clearance in patients with se...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066619901095
更新日期：2020-01-22 00:00:00
abstract：:Combined poisoning with calcium-channel blockers and beta-blockers is usually associated with severe heart failure. This report shows the effectiveness of emergency extracorporeal life support in treating life-threatening simultaneous propranolol and verapamil intoxication. A 15-year-old girl presented in cardiogenic ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066607307528
更新日期：2007-11-01 00:00:00
abstract：:This was a retrospective observational study in a pediatric intensive care unit, in which 19 patients received levosimendan. There were no adverse events attributable to levosimendan and no instances where the clinical condition worsened after administration. Arterial lactate levels decreased significantly following l...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066606287039
更新日期：2006-05-01 00:00:00
abstract：:Decision-making for the hospitalized dying and critically ill is often characterized by an understanding of autonomy that leads to clinical care and outcomes that are antithetical to patients' preferences around suffering and quality of life. A better understanding of autonomy will facilitate the ultimate goal of a pa...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066619870458
更新日期：2020-11-01 00:00:00
abstract：OBJECTIVE:When patients deteriorate after decannulation from extracorporeal membrane oxygenation (ECMO), a second run of extracorporeal support may be considered. However, repeat cannulation can be difficult and poor outcomes associated with multiple ECMO runs are a concern. The aim of this study was to evaluate outcom...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620981903
更新日期：2020-12-22 00:00:00
abstract：:The treatment of sepsis is an ongoing challenge for clinicians; despite the wide choice of effective antibiotics to treat infection, sepsis remains the leading cause of morbidity and mortality for patients admitted to an intensive care unit. Dysregulation of the immune response is now recognized to be a key factor in ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066611425759
更新日期：2013-09-01 00:00:00
abstract：:Video laryngoscopy has demonstrated utility in airway management. For the present case series, we report the use of video laryngoscopy to evaluate the airway of critically ill, mechanically ventilated patients, as a means to reduce the risk of immediate postextubation stridor by assessing the degree of laryngeal edema...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066612437528
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND:Ischemic and hypoxic secondary brain insults are common and detrimental in traumatic brain injury (TBI). Treatment aims to maintain an adequate cerebral blood flow with sufficient arterial oxygen content. It has been suggested that arterial hyperoxia may be beneficial to the injured brain to compensate for c...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620944097
更新日期：2020-07-27 00:00:00
abstract：OBJECTIVE:Fluid responsiveness is the ability to increase the cardiac output in response to a fluid challenge. Only about 50% of patients receiving fluid resuscitation for acute circulatory failure increase their stroke volume, but the other 50% may worsen their outcome. Therefore, predicting fluid responsiveness is ne...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,meta分析
doi：10.1177/0885066617752308
更新日期：2020-04-01 00:00:00
abstract：:Cardiomyopathy secondary to toxic shock syndrome (TSS) is an uncommon but potentially life-threatening problem. We report the case of a 51-year-old male who presented with profound cardiogenic shock and multiorgan failure that could not be managed by conventional therapy with intravenous fluids, vasopressors and inotr...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066613517069
更新日期：2015-02-01 00:00:00
abstract：:Neurologic complications of cancer are common and are frequently life-threatening events. Certain neurologic emergencies occur more frequently in the cancer population, specifically elevated intracranial pressure, epidural cord compression, status epilepticus, ischemic and hemorrhagic stroke, central nervous system in...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066615619582
更新日期：2017-02-01 00:00:00
abstract：:Realizing the vast medical benefits of validated protocols, recommendations and practice guidelines requires acceptance and implementation by frontline care providers. Knowledge translation is the science of accelerating the transfer of knowledge to practice by understanding and creatively addressing the barriers that...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,实务指引
doi：10.1177/0885066610387988
更新日期：2011-05-01 00:00:00
abstract：:Objectives: Standard management strategies for lowering intracranial pressure (ICP) in traumatic brain injury has been well-studied, but the use of lesser known interventions for ICP in subarachnoid hemorrhage (SAH) remains elusive. Searches were performed in PubMed and EBSCO Host to identify best available evidence f...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066618813073
更新日期：2020-03-01 00:00:00
abstract：:Neurogenic stunned myocardium (NSM) is a triad of transient left ventricular dysfunction, electrocardiogram changes, and elevation in cardiac enzymes, often mimicking a myocardial infarction. It has been described following acute brain injury. The purported mechanism is catecholamine excess resulting in cardiac dysfun...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066613511054
更新日期：2015-09-01 00:00:00
abstract：:A review of adults with septic arthritis was undertaken to evaluate outcome of treatment and intensive care requirements in a community-based teaching hospital. During an 80-month period (1986-1992), 38 cases of septic arthritis were identified. Underlying joint disease was present in 84% of patients. Mean age was 68 ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/088506669501000507
更新日期：1995-09-01 00:00:00
abstract：:Despite an overall decline in the incidence of tuberculosis (TB), the percentage of cases representing miliary TB has remained stable. We report 2 cases of fatal miliary TB that remained unrecognized until autopsy, occurring within a 6-month period at 1 Detroit institution. These cases represent the wide range of pres...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066605279150
更新日期：2005-11-01 00:00:00
abstract：:Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shoc...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066618762747
更新日期：2018-12-01 00:00:00
abstract：INTRODUCTION:The invasive nature and potential complications associated with pulmonary artery (PA) catheters (PACs) have prompted the pursuit of less invasive monitoring options. Before implementing new hemodynamic monitoring technologies, it is important to determine the interchangeability of these modalities. This st...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066614530085
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:At this time, there are no studies evaluating the risk of delirium or coma with the use of ketamine in mechanically ventilated adult patients, compared to conventional therapies such as propofol or dexmedetomidine. OBJECTIVE:The objective of this study was to evaluate the number of days alive without deliri...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066618767619
更新日期：2020-06-01 00:00:00
abstract：:Pulmonary embolus (PE) is estimated to cause 200 000 to 300 000 deaths annually. Many deaths occur in hemodynamically unstable patients and the estimated mortality for inpatients with hemodynamic instability is between 15% and 25%. The diagnosis of PE in the critically ill is often challenging because the presentation...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066610392658
更新日期：2011-09-01 00:00:00
abstract：BACKGROUND:In the setting of the COVID pandemic, many patients falling ill with acute respiratory distress syndrome eventually require prone positioning for gas exchange. Traditionally, central venous catheters are inserted with patient in the supine or Trendelenburg position. However, when a patient cannot tolerate su...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066620959649
更新日期：2020-09-16 00:00:00
abstract：BACKGROUND:The efficacy of low-dose hydrocortisone therapy in the management of septic shock remains controversial in critical care for many years. Hence, we performed this meta-analysis of randomized controlled trials (RCTs) with trial sequential analysis (TSA) to evaluate its effect on clinical outcome among adult pa...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066618803062
更新日期：2020-10-01 00:00:00
abstract：PURPOSE:Bloodstream infections (BSIs) caused by Acinetobacter species have been extensively reported, however, which majorly focused on respiratory tract infections. The risk of mortality and the effect of early catheter removal on survival in catheter-related BSIs (CRBSIs) caused by Acinetobacter spp. remain unclear. ...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,多中心研究
doi：10.1177/0885066616677710
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:Atrial fibrillation (AF) portends poor prognoses in intensive care unit patients with sepsis. However, AF research is challenging: Previous studies demonstrate that International Classification of Disease (ICD) codes may underestimate the incidence of AF, but chart review is expensive and often not feasible....
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/0885066619866172
更新日期：2019-10-01 00:00:00
abstract：:Aspergillus fumigatus hyphae is often found in the lung tissue of patients with bronchocentric granulomatosis (BCG). This organism is believed to be one agent responsible for inciting the hypersensitivity response and subsequent development of the characteristic pathology that defines BCG. The definitive etiology of t...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章
doi：10.1177/088506669501000106
更新日期：1995-01-01 00:00:00
abstract：:Left ventricular assist devices (LVADs) and total artificial hearts (TAHs) are surgically implanted as permanent treatment of unrecoverable heart failure. Both LVADs and TAHs are durable mechanical circulatory support (MCS) devices that can prolong patient survival but also alter end-of-life trajectory. The permissibi...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066611432415
更新日期：2014-01-01 00:00:00
abstract：:Echodynamics refers to the use of echocardiography as hemodynamic tool mostly in intensive and acute care settings. It implies a smooth drift from the classic cardiology use to a more critical care adjusted use. A more personalized approach is advocated in critical care, and echo is one way to reach such goal. Correct...
journal_title：Journal of intensive care medicine
pub_type： 杂志文章,评审
doi：10.1177/0885066617734151
更新日期：2018-08-01 00:00:00
