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 patient-centered approach and ensure compassionate, high-quality care that respects our patients' values. We reviewed the medical literature and our experiences through the ethics service, palliative care service, and critical care service of a large community teaching hospital. The cumulative experience of a senior intensivist was filtered through the lens of a medical ethicist and the palliative care team. The practical application of patient-centered care was discerned from these interactions. We determined that a clearer understanding of patient-centeredness would improve the experience and outcomes of care for our patients as well as our adherence to ethical practice. The practical applications of autonomy and patient-centered care were evaluated by the authors through clinical interactions on the wards to ascertain problems in understanding their meaning. Clarification of autonomy and patient-centeredness is provided using specific examples to enhance understanding and application of these principles in patient-centered care.
journal_name
J Intensive Care Medjournal_title
Journal of intensive care medicineauthors
Mapes MV,DePergola PA,McGee WTdoi
10.1177/0885066619870458subject
Has Abstractpub_date
2020-11-01 00:00:00pages
1352-1355issue
11eissn
0885-0666issn
1525-1489journal_volume
35pub_type
杂志文章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::The authors retrospectively review their experience with low immunoglobulin G (IgG) levels in a pediatric ICU population over a 12-month period. The total IgG level was below the normal for age in 14 of the 20 patients. The 14 patients with a low IgG level were younger and weighed less when compared with the 6 patient...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066603255905
更新日期:2003-09-01 00:00:00
abstract::Frontal chest radiographs are the principal diagnostic imaging study to detect, verify, or exclude acute thoracic injury after trauma, and they should be obtained as quickly as possible without compromising clinical assessment and resuscitation. Chest radiographs provide important information about potentially life-th...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669400900403
更新日期:1994-07-01 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::Early predictors of prognosis in comatose patients post cardiac arrest help inform decisions surrounding continuation or withdrawal of treatment and provide a framework on which to better inform relatives of the likely outcome. Markers defined prior to the widespread use of therapeutic hypothermia post arrest may no l...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066613511045
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Use of checklists brings about improvements in a variety of patient outcomes. Nevertheless, whether compliance with a nurse-led intensive care unit (ICU) checklist produces the same effect is currently unknown. METHODS:This is a retrospective analysis of data obtained during the implementation of a quality ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066614533910
更新日期:2016-05-01 00:00:00
abstract::Brain blood flow tests with diffusible radiopharmaceuticals are often done as an ancillary test in brain death (BD). We report a case of an infant with absent brain blood flow on an anterior planar image despite persistent breathing and extensor posturing. We reviewed the literature from 1980 to 2008 using MEDLINE and...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066609355388
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Predicting the mortality from post-operative sepsis remains a continuing problem. We built a statistical model using national data to predict mortality in patients who developed post-operative sepsis. METHODS:This is a retrospective study using the American College of Surgeons National Quality Surgical Impr...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620960991
更新日期:2020-10-12 00:00:00
abstract::Fever after cardiac surgery in children may be due to bacterial infection or noninfectious origin like systemic inflammatory response syndrome (SIRS) secondary to bypass procedure. A marker to distinguish bacterial from nonbacterial fever in these conditions is clinically important. The purpose of our study was to eva...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066610396642
更新日期:2012-05-01 00:00:00
abstract::With the introduction of highly active antiretroviral therapy (HAART), HIV has become a chronic disease. As HIV-infected patients are aging, they are at increased risk for comorbid diseases. These non-AIDS related diseases account for a growing proportion of intensive care unit (ICU) admissions in HIV-infected patient...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610387996
更新日期:2011-05-01 00:00:00
abstract:INTRODUCTION:Visualization of B-lines via lung ultrasound provides a non-invasive estimation of pulmonary hydration. Extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) assessed by transpulmonary thermodilution (TPTD) represent the most validated parameters of lung water and alveoloc...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620967655
更新日期:2020-11-05 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:BACKGROUND:Diagnosing acute kidney injury (AKI) stage 3 in critically ill patients may help physicians in making treatment decisions. This diagnosis relies chiefly on urinary output and serum creatinine, which may be of limited value. This study aimed to explore the diagnostic performance of renal resistive index (RRI)...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066619887333
更新日期:2021-01-01 00:00:00
abstract::Renal replacement therapy in the intensive care unit can vary from simple procedures to very complex technologies. I discuss the factors that contribute to the decisions regarding the selection of a specific therapy. These factors include immediate and intermediate therapeutic goals (e.g., solute removal, dehydratio...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/088506669200700604
更新日期:1992-11-01 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::Relocation of large numbers of critically ill patients between hospitals is sometimes necessary and the risks associated with relocation may be high. In the setting of adherence to an interhospital intensive care unit (ICU) relocation protocol, we aimed to determine whether the interhospital relocation of all ICU pati...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066617726754
更新日期:2019-11-01 00:00:00
abstract:INTRODUCTION:The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe se...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,meta分析
doi:10.1177/0885066616671710
更新日期:2018-05-01 00:00:00
abstract::The whole-brain criterion of death provides that a person who has irreversibly lost all clinical functions of the brain is dead. Bedside brain death (BD) tests permit physicians to determine BD by showing that the whole-brain criterion of death has been fulfilled. In a nonsystematic literature review, we identified an...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066618784268
更新日期:2020-08-01 00:00:00
abstract:PURPOSE:The strategy used to improve effective checklist use in intensive care unit (ICU) setting is essential for checklist success. This study aimed to test the hypothesis that an electronic checklist could reduce ICU provider workload, errors, and time to checklist completion, as compared to a paper checklist. METH...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066614558015
更新日期:2016-03-01 00:00:00
abstract::We report the success rate and complications of peripherally inserted central catheters (PICCs) in patients hospitalized in an intensive care unit (ICU). We performed a cohort study in the ICU of a large tertiary care, university-affiliated community hospital. All ICU patients for whom their attending physicians reque...
journal_title:Journal of intensive care medicine
pub_type: 临床试验,杂志文章
doi:10.1177/088506669601100107
更新日期:1996-01-01 00:00:00
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::Respiratory complications before and after liver transplant are common, diverse, and potentially have a negative impact on patient outcomes. In this review, we discuss the most frequent respiratory conditions that patients may develop in the perioperative period. Their prevention and/or treatment may help to maximize ...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066618781526
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVES:We report the case of a 28-year-old patient with systemic lupus erythematosus (SLE) with rapid onset of dyspnea and hemoptysis found to have diffuse alveolar hemorrhage (DAH) with refractory hypoxemia successfully treated with venovenous extracorporeal membrane oxygenation (ECMO). The discussion includes cli...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066612464335
更新日期:2014-03-01 00:00:00
abstract::Longitudinal clivus fractures are rare in children, with only 5 cases published in the English literature to date. Clivus fractures, particularly longitudinal type, are associated with high mortality and morbidity. We report a case of longitudinal clivus fracture in a teenager with survival and complete neurological r...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066614555481
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Morbidity associated with stress ulcer-related bleeding, the cost of medications, and the possible complications associated with stress ulcer prophylaxis are important considerations when prescribing prophylaxis. We prospectively studied the prescription patterns for stress ulcer prophylaxis in patients admi...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,多中心研究
doi:10.1177/0885066612453542
更新日期:2014-03-01 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:BACKGROUND:Pharmacogenomic (PGx) testing has the potential to provide information on specific drug-metabolizing enzymes that may lead to an absence, reduction, or increase in medication effect in patients. There is a paucity of prospective studies examining PGx testing in the intensive care unit (ICU) setting. RESEARC...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章
doi:10.1177/0885066620946303
更新日期:2020-07-31 00:00:00
abstract::Diabetes mellitus (DM) represents an enormous health care concern for the United States and other countries. According to the American Diabetes Association in 2007, there were more than 23 million Americans living with diabetes. This is a 13.5% increase from 2005, likely representing increases in Type II DM (DMII). Di...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066610396813
更新日期:2012-07-01 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::Hyponatremia is the most frequently occurring electrolyte abnormality and can lead to life-threatening complications. This disorder may be present on admission to the intensive care setting or develop during hospitalization as a result of treatment or multiple comorbidities. Patients with acute hyponatremia or symptom...
journal_title:Journal of intensive care medicine
pub_type: 杂志文章,评审
doi:10.1177/0885066614566794
更新日期:2016-05-01 00:00:00