2,833 publications from this institution
Risk-standardized septic shock mortality rates varied considerably between hospitals, suggesting that septic shock is an important performance target. However, efforts to profile hospital performance were sensitive to septic shock case definitions, suggesting that septic shock mortality is not currently ready for widespread use as a hospital quality measure.
SCOPUS: no.j
Many biomarkers have been evaluated for use in sepsis. Most of the biomarkers had been tested clinically, primarily as prognostic markers in sepsis; relatively few have been used for diagnosis. None has sufficient specificity or sensitivity to be routinely employed in clinical practice. PCT and CRP have been most widely used, but even these have limited ability to distinguish sepsis from other inflammatory conditions or to predict outcome.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Intermountain Medical Center; and University of Utah School of Medicine, Salt Lake City, UT Division of Research, Kaiser Permanente Northern California, Oakland, CA *See also p. 1371. Dr. Peltan’s institution received funding from Asahi Kasei Pharma, and he received funding (unrelated to the present work) from Janssen Pharmaceuticals. Dr. Liu’s institution received funding from the National Institutes of Health (NIH) R35GM128672, and he received support for article research from the NIH.
One of the many potential sequelae of intensive care is prolonged weakness, which can be associated with increased morbidity during the intensive care unit stay and long-term functional disability. Despite increased awareness of this complication in recent years, diagnosing intensive care unit-acquired weakness remains difficult and there are no specific therapies. Management, therefore, relies on limiting its short- and long-term effects. One method by which this may be achieved is to reduce sedative use and promote early mobilization and exercise.
Acute cardiac syndromes are common and responsible for considerable mortality and morbidity. Decision making in such patients can be difficult clinically but can also be complex and challenging from an ethical perspective. This chapter reviews some of the ethical problems, including organ donation and withholding/withdrawing, that can occur in the acutely ill adult cardiac patient, starting with a brief look at the ethical principles that should guide our decision making: beneficence, non-maleficence, autonomy, and distributive justice. The role of advance directives and considerations related to family presence during cardiopulmonary resuscitation will also be discussed. With the increasing incidence and prevalence of coronary artery disease worldwide, the number of patients with cardiac arrest and requiring acute cardiac care is going to increase, and doctors will increasingly be faced with difficult ethical decisions associated with these patients. Open discussion and debate about these issues and good communication among patients, family members, and members of the health care team are essential to ensure that all patients receive the best possible end-of-life care.
