Advertisement

Is Reduction in Mortality in Intensive Care Just Another Holy Grail?

  • A. Petros
  • R. van Saene
Conference paper

Abstract

Almost every month another study is published which casts doubts upon yet another well established and fondly held practice in intensive care. Resulting in the temporary rejection of a well tried manoeuvre or a promising new therapy, until the results of an opposing study restores the practice to its pride of place in our estimation.

Keywords

Cerebral Malaria Multiple Organ Dysfunction Score Monocyte Deactivation Pulmonary Artery Flotation Catheter Temporary Rejection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Eidelman LA, Sprung CL (1994) Why have new therapies for sepsis not been developed? Crit Care Med 22: 1330–1334PubMedCrossRefGoogle Scholar
  2. 2.
    Zeni F, Freeman B, Nathanson C (1997) Anti-inflammatory therapies to treat sepsis and septic shock: A reassessment. Crit Care Med 25: 1095–1100PubMedCrossRefGoogle Scholar
  3. 3.
    Docke W-D, Randow F, Syrbi U et al (1997) Monocyte deactivation in septic patients: restoration by IFN-γ treatment. Nature 3: 678–681CrossRefGoogle Scholar
  4. 4.
    Cross AS (1994) Anti-endotoxin antibodies: a dead end? Ann Int Med 121: 58–59PubMedGoogle Scholar
  5. 5.
    Jacobs P, Noseworthy TW (1990) National estimates of intensive care utilization and costs: Canada and the United States. Crit Care Med 18: 1282–1286PubMedCrossRefGoogle Scholar
  6. 6.
    Alexander HR, Sheppard BC, Jensen JC et al (1991) Treatment with recombinant human tumor necrosis factor-alpha protects rats against the lethality, hypotension and hypothermia of gram negative sepsis. J Clin Invest 88: 34–39PubMedCrossRefGoogle Scholar
  7. 7.
    Romani L, Puccetti P, Mencacci A et al (1994) Neutralization of IL-10 up-regulates nitric oxide production and protects susceptible mice from challenge with Candida albicans. J Immunol 152: 3514–3521PubMedGoogle Scholar
  8. 8.
    Lau J, Antman EM, Jimenez-Silva J et al (1992) Cumulative meta-analysis of therapeutic trials for myocardial infarction. N Engl J Med 327: 248–254PubMedCrossRefGoogle Scholar
  9. 9.
    Knaus WA, Harrell FE, Fisher CJ et al (1993) The clinical evaluation of new drugs for sepsis: a prospective study design based on survival analysis. JAMA 270: 1233–1241PubMedCrossRefGoogle Scholar
  10. 10.
    UK collaborative ECMO trial steering group (1996) UK collaborative randomised trial of neonatal extra-corporeal membrane oxygenation. Lancet 348: 75–82CrossRefGoogle Scholar
  11. 11.
    Heyland DK, Cook DJ, Guyatt GH (1993) Enterai nutrition in the critically ill patient: a critical review of the evidence. Int Care Med 19: 435–442CrossRefGoogle Scholar
  12. 12.
    Hayes MA, Timmins AC, Yau EHS et al (1994) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330: 1717–1722PubMedCrossRefGoogle Scholar
  13. 13.
    Thompson BT, Cockrill BA (1994) Renal-dose dopamine: a Siren song? Lancet 344: 7–8PubMedCrossRefGoogle Scholar
  14. 14.
    Shoemaker WC (1990) Use and abuse of the balloon tip pulmonary artery (Swan-Ganz) catheter: Are patients getting their money’s worth? Crit Care Med 18: 1294–1296PubMedCrossRefGoogle Scholar
  15. 15.
    Connors AF Jr, Speroff T, Dawson NV et al (1996) The effectiveness of right heart catheterization in the initial care of critically ill patients. Jama 18: 889–897CrossRefGoogle Scholar
  16. 16.
    Nystrom B (1994) Impact of handwashing on mortality in intensive care: examination of the evidence. Infect Control Hosp Epidemiol 15: 435–436PubMedCrossRefGoogle Scholar
  17. 17.
    Bone RC, Fisher CJ Jr, Clemmer TP et al (1987) A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317: 653–658PubMedCrossRefGoogle Scholar
  18. 18.
    Hoffman SL, Punjabi NH, Kumalas S et al (1984) Reduction of mortality in chloramphenicol treated severe typhoid fever by high-dose dexamethasone. N Engl J Med 310: 82–88PubMedCrossRefGoogle Scholar
  19. 19.
    Derkx B, Taminiau J, Radema S et al (1993) Tumour-necrosis-factor antibody treatment in Crohn’s disease. Lancet 342: 173–174PubMedCrossRefGoogle Scholar
  20. 20.
    Kwiatkowski D, Molyneux ME, Stephens S et al (1993) Anti-TNF therapy inhibits fever in cerebral malaria. Quart J Med 86: 91–98PubMedGoogle Scholar
  21. 21.
    Deyo RA, Inui TS, Leininger JD, Overman SS (1983) Measuring functional outcomes in chronic disease: A comparison of traditional scales and a self-administered health status questionnaire in patients with rheumatoid arthritis. Med Care 21: 180–192PubMedCrossRefGoogle Scholar
  22. 22.
    Guyatt GH, Mitchell A, Irvine EJ et al (1989) A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterol 96: 804–810Google Scholar
  23. 23.
    Hurel D, Loirat P, Saulnier E et al (1997) Quality of life 6 months after intensive care: results of a prospective multicenter study using a generic health status scale and satisfaction scale. Int Care Med 23: 331–337CrossRefGoogle Scholar
  24. 24.
    Nicholas R, Broldo PP, Condon R et al (1973) Effect of preoperative neomycin-erythromycin intestinal preparation on the incidence of infectious complications following colon surgery. Ann Surg 178: 453–462CrossRefGoogle Scholar
  25. 25.
    van der Meer JTM, van Wijk W, Thompson J et al (1992) Efficacy of antibiotic prophylaxis for prevention of native-valve endocarditis. Lancet 339: 135–139PubMedCrossRefGoogle Scholar
  26. 26.
    Marshall JC, Cook DJ, Christou NV et al (1995) Multiple organ dysfunction score: a reliable detector of complex clinical outcome. Crit Care Med 23: 1638–1652PubMedCrossRefGoogle Scholar
  27. 27.
    Atkinson S, Bihari D, Smithies M et al (1994) Identification of futility in intensive care. Lancet 344: 1203–1206PubMedCrossRefGoogle Scholar
  28. 28.
    Brooks R, Kerridge R, Hillman K et al (1997) Quality of life outcomes after intensive care. Comparison with a community group. Int Care Med 23: 581–586CrossRefGoogle Scholar
  29. 29.
    Smith R (1991) Where is the wisdom...? The poverty of medical evidence. BMJ 303: 798–799PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1998

Authors and Affiliations

  • A. Petros
  • R. van Saene

There are no affiliations available

Personalised recommendations