Abstract:
OBJECTIVE:To evaluate whether current criteria for the diagnosis of brain death fulfill the requirement for the "irreversible cessation of all functions of the entire brain, including the brainstem." DATA SOURCES:Clinical, philosophical, legal, and public policy literature on the subject of brain death. DATA EXTRACTION/SYNTHESIS:We advance four arguments to support the view that patients who meet the current clinical criteria for brain death do not necessarily have the irreversible loss of all brain function. First, many clinically brain-dead patients maintain hypothalamic-endocrine function. Second, many maintain cerebral electrical activity. Third, some retain evidence of environmental responsiveness. Fourth, the brain is physiologically defined as the central nervous system, and many clinically brain-dead patients retain central nervous system activity in the form of spinal reflexes. We explore options for resolving these inconsistencies between the conceptual definition and the clinical criteria used to make the diagnosis of brain death. CONCLUSIONS:Brain death is a valid conception of death because it signifies the permanent loss of consciousness. Brain death criteria should therefore be based on the diagnosis of the permanent loss of consciousness rather than that of the loss of vegetative brain functions. Revision of our current "whole brain" definition of brain death to a "higher brain" standard should be considered.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Truog RD,Fackler JCdoi
10.1097/00003246-199212000-00018subject
Has Abstractpub_date
1992-12-01 00:00:00pages
1705-13issue
12eissn
0090-3493issn
1530-0293journal_volume
20pub_type
杂志文章,评审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:OBJECTIVES:Anxiety results from the anticipation of a threat and might be associated with poor outcome in the critically ill. This study aims at showing that anxiety at admission in critically ill patients is associated with new organ failure over the first 7 days of ICU hospitalization independently of baseline organ ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000004495
更新日期:2020-10-01 00:00:00
abstract::Mucus plugging of a large airway resulted in the formation of a check-valve mechanism and pulmonary hyperinflation, rather than atelectasis. Fiberoptic bronchoscopy was both diagnostic and curative. The physician should be aware that mucus plugging may have unusual presentations and may mimic other clinical entities. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198609000-00015
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:To study the epidemiology, style of management, and outcome of intensive care patients with acute renal failure requiring replacement therapy in Australia. DESIGN:Prospective epidemiologic study. SETTING:Australian adult intensive care units providing acute renal replacement therapy. PATIENTS:Adult intensi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200110000-00010
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVES:Extracellular mitochondrial DNA and N-formyl peptides released following tissue damage may contribute to systemic inflammation through stimulation of the innate immune system. In this review, we evaluate existing in vivo human data regarding a role for mitochondrial DNA and N-formyl peptides in producing sys...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003381
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To cost adult intensive care by determining inputs to production, resource consumption per patient, and total cost per intensive care unit (ICU) stay. DESIGN:Prospective cost-accounting analysis of each patient stay in the ICU, over a 1-yr period. SETTING:An 11-bed, medical/surgical adult ICU, in a 932-bad ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199607000-00017
更新日期:1996-07-01 00:00:00
abstract::The recommended rates for closed-chest cardiac compressions during CPR are based on physiologic variations with increasing age rather than experimental data. Using puppies, we compared mean arterial pressure, cardiac index (CI), and cerebral blood flow (CBF) at a slow (40/min, group 1) and a rapid (120/min, group 2) r...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198710000-00009
更新日期:1987-10-01 00:00:00
abstract::This study was performed to determine if particulate material within the pulmonary vascular bed could be sampled by aspirating blood from a wedged pulmonary artery catheter. 99mTechnetium-labeled albumin microspheres (20 micrometers) were injected and embolized into the precapillary pulmonary vasculature of 6 critical...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198304000-00001
更新日期:1983-04-01 00:00:00
abstract::We report a case of an amniotic fluid embolism (AFE) causing a cardiorespiratory arrest associated temporally with ingestion of castor oil in a full-term normal pregnancy. Risk factors usually associated with AFE were not found in this patient. ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198806000-00016
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:To review the history and development of critical care nurses, the supply and demand issues related to critical care nursing, critical care nursing's contribution to patient outcomes, and recommendations to ensure a steady and strong workforce. DATA SOURCE AND SELECTION:Information presented in this article ...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000203087.42439.53
更新日期:2006-03-01 00:00:00
abstract::Twenty-seven surgical patients who developed post-extubation hypoxemia unresponsive to routine respiration therapy (incentive spirometry and chest physical therapy) received continuous positive airway pressure (CPAP) delivered through a mask at an inspired oxygen fraction (FIO2) of 0.45. All patients responded with an...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198501000-00012
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVES:ICU admission delays can negatively affect patient outcomes, but emergency department volume and boarding times may also affect these decisions and associated patient outcomes. We sought to investigate the effect of emergency department and ICU capacity strain on ICU admission decisions and to examine the ef...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002993
更新日期:2018-05-01 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::As of October 1985, 37 candidates have passed the final examination in intensive care for the Diploma of Fellow of the Faculty of Anaesthetists, Royal Australasian College of Surgeons (FFARACS). In September 1984, 23 of these successful candidates responded to a questionnaire seeking information on their educational e...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198606000-00015
更新日期:1986-06-01 00:00:00
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
更新日期:2005-08-01 00:00:00
abstract::Previously, we determined that a colloid concentration of about 3% was optimal for resuscitation of lethal ischemic intestinal shock model in rats. Maximal volumes of lactated Ringer's solution (RL) alone only expanded plasma volume (PV) to 80% of preshock level, while increasing volumes of 3% albumin (ALB) in RL line...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199001000-00014
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the epidemiology of hyperammonemia unrelated to liver failure in the critical care setting. DESIGN:Retrospective case series. SETTING:Critically ill patients admitted to ICUs at Mayo Clinic, Rochester, MN (medical ICU, two mixed medical-surgical ICUs, coronary care unit, or the cardiosurgical I...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003278
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Carbon monoxide (CO), an endogenous byproduct of heme metabolism, is produced at high levels in injured tissue via induction of heme-oxygenase-1 activity, where it contributes to the modulation of proinflammatory processes. Alone, CO has potent anti-inflammatory effects in models of acute and chronic inflamma...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000166349.76514.40
更新日期:2005-06-01 00:00:00
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
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:Preclinical studies reveal the neuroprotective properties of xenon, especially when combined with hypothermia. The purpose of this study was to investigate the feasibility and cardiac safety of inhaled xenon treatment combined with therapeutic hypothermia in out-of-hospital cardiac arrest patients. DESIGN:A...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0b013e31828a4337
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVES:Ethicists advise that life-sustaining treatment decisions should be made in keeping with patient preferences. Until recently, there has been little systematic study of the impact of patient preferences on the use of various life-sustaining treatments or the consequent cost of hospital care. This prospective ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199611000-00009
更新日期:1996-11-01 00:00:00
abstract:OBJECTIVE:First, to determine whether procalcitonin (PCT) significantly adds diagnostic value in terms of sensitivity and specificity to a common set of markers of infection, including C-reactive protein (CRP), at the Emergency Department. Second, to create a simple scoring rule implementing PCT values. Third, to deter...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181b9ec33
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVE:Heptafluoropropane is an inert gas commercially used as propellant for inhalers. Since heptafluoropropane can be detected in low concentrations, it could also be used as a tracer gas to measure functional residual capacity and ventilation homogeneity. The aim of the present study was to validate functional re...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000220065.93507.AB
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact of a newly appointed neurointensivist on neurosciences intensive care unit (NICU) patient outcomes and quality of care variables. DESIGN:Observational cohort with historical controls. SETTING:Ten-bed neurointensive care unit in tertiary university hospital. PATIENTS:Mortality, length...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000146131.03578.21
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:Acute aneurysmal subarachnoid hemorrhage (SAH) is a complex multifaceted disorder that plays out over days to weeks. Many patients with SAH are seriously ill and require a prolonged intensive care unit stay. Cardiopulmonary complications are common. The management of patients with SAH focuses on the anticipat...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0b013e318195865a
更新日期:2009-02-01 00:00:00
abstract::Pulmonary artery wedge pressure (PAWP) will only reflect left atrial pressure (LAP) if continuity of fluid exists from the catheter tip to the left atrium. Either increased airway pressure or decreased hydrostatic pressure may lead to discontinuity of the fluid column and midinterpretation of PAWP. Simultaneous measur...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-197801000-00009
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVE:To investigate the mechanism by which methylprednisolone protects the liver from hypoxia-induced injury. DESIGN:Prospective control study using the isolated rat liver. SETTING:Animal research facility. SUBJECTS:Male, fasted, pathogen-free Sprague-Dawley rats. INTERVENTIONS:Low-flow hypoxia was produced by...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000066176.49774.CC
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:To assess the feasibility, biochemical efficacy, and safety of liberal versus conventional glucose control in ICU patients with diabetes. DESIGN:Prospective, open-label, sequential period study. SETTING:A 22-bed mixed ICU of a tertiary hospital in Australia. PATIENTS:We compared 350 consecutive patients w...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000003087
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:With limited community services, the complex rehabilitation period after critical illness is often the responsibility of family members who, as a result, may experience negative health outcomes. The objectives of this research were to a) identify aspects of the caregiving situation that are associated with ca...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000190428.71765.31
更新日期:2006-01-01 00:00:00
abstract::It was found that, during 1974, it cost an average of $8842 ($12,909 in 1979) to care for a survivor of severe respiratory distress syndrome (RDS) who required mechanical ventilation in this ICU compared to $2448 ($3574 in 1979) for nonsurvivors. Death in 15 out of the 16 nonsurvivors was accompanied by grade III-IV i...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198102000-00005
更新日期:1981-02-01 00:00:00