Bóa cáo y học: "Ethics review: Perioperative do-not-resuscitate orders – doing ‘nothing’ when ‘something’ can be done" pptx
Bóa cáo y học: "Ethics review: Perioperative do-not-resuscitate orders – doing ‘nothing’ when ‘something’ can be done" pptx
... do-not-resuscitate orders – doing ‘nothing’ when ‘something’ can be doneMark Ewanchuk1,2and Peter G Brindley21Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada2Division ... wonder that perioperative care providers may have substantial difficultywith do-not-resuscitate (DNR) orders. However, as many as15% of patients with DNR orders will undergo surgery,whether ... clinical ethicists). Should the patient ultimately die,then the OR may be out of service for hours. Many otherprocedures may be subsequently postponed or cancelled. Allin all, the OR is a poor environment...
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Ethics review: Perioperative do-not-resuscitate orders – doing ‘nothing’ when ‘something’ can be done docx
... do-not-resuscitate orders – doing ‘nothing’ when ‘something’ can be doneMark Ewanchuk1,2and Peter G Brindley21Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada2Division ... wonder that perioperative care providers may have substantial difficultywith do-not-resuscitate (DNR) orders. However, as many as15% of patients with DNR orders will undergo surgery,whether ... anaesthesiologists may be appropriately sceptical of what they read in the patient’schart; after all, up until that time, they probably know littleabout the patient. In addition, the surgeon may not be thepatient’s...
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Báo cáo y học: "Ethics review: Long-term outcomes and clinical predictors of hospital mortality in very long stay intensive care unit patients: a cohort study" pptx
... Bixby K: Long-termoutcome when major complications follow coronary arterybypass graft surgery. Recovery after complicated coronaryartery bypass graft surgery. Chest 1996, 110:1394-1398.5. Ryan ... number of ventilator daysHospital survival by number of ventilator days. se, standard error.Figure 1Hospital survival by number of ICU daysHospital survival by number of ICU days. ICU, intensive ... shorter ICUstays, and the predictive value of admission scoring systemsbased on acute physiological derangements decreases signif-icantly beyond 7 days [24]. Given the challenges posed bythis patient...
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Báo cáo y học: "Ethics review: Strong ion difference in urine: new perspectives in acid–base assessment" docx
... urinary SID. Unfortunately,no such investigation has been conducted in critically illpatients. As discussed above, SID has been studied incomparison with base excess but without any physiologicalrationale ... given time ‘t’ may be derived from a seriesof equations, which may appear to be complicated in theirexpression but simple in their meaning. Eqn 3 (below)indicates that, in a system, the net ... sum of [HCO3 – ],[A – ] and [H2PO4 – ], where A – are the weak acids in dissociated form,mainly albumin). During acidosis, SID decreases but the law of electro-neutrality is still satisfied....
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Bóa cáo y học: "Clinical review: Thyroid hormone replacement in children after cardiac surgery – is it worth a try" docx
... coronary artery bypass graft; CBP = cardiopulmonary bypass; IL = interleukin; SES = sick euthyroid syndrome; SIRS = systemic inflam-matory response syndrome; T3 = triiodothyronin; T4 = thyroxin; ... of stay and low mortalityand morbidity in the majority of clinical circumstances.Nevertheless, clinically significant SES can be detected,especially in neonates and children with long bypass ... surgery using cardiopulmonary bypass produces ageneralized systemic inflammatory response, resulting in increasedpostoperative morbidity and mortality. Under these circumstances,a typical...
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Báo cáo y học: "Ethics review: End of life legislation - the French model" pptx
... significant burden of symptoms of post-traumaticstress disorder among family members [18], and a significantamount of conflict within the ICU team or between the teamand family members around ... decreasing psycho-logical distress for family members and reducing conflictsamong ICU team members and between team and familymembers; and by reducing the number of concealedeuthanasia procedures ... the limitation orstopping of treatment. They can be revoked by the person atany time.Provided that they were established less than three yearsbefore the state of unconsciousness of the person,...
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Báo cáo y học: "Increase in markers of airway inflammation after ozone exposure can be observed also in stable treated " ppsx
... exposure, we may hypothesize thatthe oxidative stress induced by ozone in the airwayepithelium may be one of several mechanisms o frecruitment and activation of neutrophils in the airways. When both ... MassimoCorradi from the University of Parma (Italy) for performing the genotypiccharacterization of the patients. The study was supported by a grant of theItalian Ministry of University and of Scientific ... authors has any competing interest to declare.Received: 30 December 2008Accepted: 19 January 2010 Published: 19 January 2010References1. Bernstein JA, Alexis N, Barnes C, Bernstein IL, Bernstein...
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Báo cáo y học: "Pro/Con debate: Should 24/7 in-house intensivist coverage be implemente" pptx
... daytime plus dedicatedcoverage by any physician during nighttime). A Canadiansurvey found that dedicated in-house physician coverageovernight was available in only 60% of ICUs by any physicianand ... critically ill patientsduring off-hours. However, this notion may not be entirelytrue; the higher mortality observed in teaching institutionsmay not be related to care delivery by in-training physiciansbut ... will significantly increase thecost related to ICU admissions, which is already very expen-sive [22]. Arguably, the system is probably cost-effective byreducing morbidity and mortality, but the...
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Báo cáo y học: "Clinical review: Evidence-based perioperative medicine" doc
... interventionsthe best evidence may be provided by a systematic review ofall relevant RCTs. However a systematic review of older,smaller or weaker studies, or demonstrating significantheterogeneity, may be ... partialpressure of oxygen. At surgical wound sites this is likely to be low due to disrupted vascular supply and decreased bloodflow perioperatively. Resistance to infection may be enhanced by the administration ... out’succinctly summarises the futility of performing a meta-analysis of poor quality studies and then imbuing thesummary statistic with any significance. The inclusion of ‘poorquality’ studies may bias...
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Bóa cáo y học: "Kinetic bed therapy to prevent nosocomial pneumonia in mechanically ventilated patients: a systematic review and meta-analysi" pps
... University of Calgary, Calgary, Alberta, Canada5Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada6Department of Medicine, University of Calgary, Calgary, Alberta, ... [18] 1990 Yes Yes No No NilFink [21] 1990 Yes No Yes Yes C, F, SA, SCDemarest [20] 1989 Yes No No Yes C, F, SASummer [26] 1989 No Yes No Yes C, F, L, SAGentilello [22] 1988 Yes No No Yes C, ... purposes)heterogeneity between subgroups being non-significant (p =0.53) (Additional file 4).Effect of kinetic bed therapy on mortalityEleven studies reported the effect of kinetic bed therapy onmortality [7,17-24,26,27]...
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