C A Manthous

..5 to 4.1, P=0.01) and documentation of consent improved. CONCLUSIONS: These results suggest that informed consent can be obtained procedure-by-procedure, as needed, at a high frequency, and with reasonable consenter comprehension...

..To examine the relationship of fluid balance and weaning outcomes...

..This article explores contributions of religion, Western medical mores, law, and emerging concepts of moral neurocognition that may explain our inherent aversion to these ideas...

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..Since critical care is a team endeavor, methods to maximize teamwork should be learned and mastered by critical care team members, and especially leaders...

..The article highlights how team principles might be used to improve patient care and navigate hospital hierarchies, and concludes with implications for future educational and scientific efforts...

..To describe intensivist-educators' practices and opinions regarding the withdrawal of life-sustaining therapies, and to juxtapose these with applicable end-of-life statutes...

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..We hypothesized that patients with septic shock who achieve negative fluid balance (< or =-500 mL) on any day in the first 3 days of management are more likely to survive than those who do not...

..This article summarizes the principle themes for this issue of Respiratory Care Clinics of North America and distills the available data to two simple weaning algorithms...

..Potential solutions for current deficiencies in end-of-life care and decision-making are discussed...

..No studies have assessed whether clinicians obtain informed consent for invasive medical procedures, and there are no explicit national standards to guide the process...

..Also, a majority (89%) of medically ill patients with P:F ratios of 120 to 200 (four of five patients with P:F ratios from 120 to 150), values sometimes used to preclude weaning, were extubated successfully...

..This case highlights both the multiple organ systems that can be involved in thyroid storm and the importance of recognizing atypical presentations of thyroid storm...

..We also suggest future study designs that would better inform the process of liberation from the ventilator and endotracheal extubation...

..We use the results of this ostensibly "negative" study to comment on the foundations for the hypothesis and logistic difficulty of studying the question...

..Most fail to involve physicians in creating directives. A significant number of those without living wills have end-of-life wishes that could be addressed by and appear open to the idea of creating advance directives...

..Larger studies are required to examine this hypothesis...

..8 times as likely to have any two risk factors compared to those who were successful. CONCLUSIONS: These simple, reproducible methods may provide a clinically useful approach to guiding the extubation of patients who have passed a SBT...

..CONCLUSION: These data suggest that cough strength, measured objectively, is a predictor of extubation outcome, morbidity, and mortality...

..Age and duration of mechanical ventilation (MV) are strongly associated with mortality and hospital discharge disposition...

..Documentation from previous bomb blasts and nuclear accidents is reviewed to assist in forecasting needs of both systems and patients in the event of an NDD in a major metropolitan area...

..Studies examining survival outcomes after in-hospital cardiopulmonary arrest (CPA) among intensive care unit (ICU) patients requiring medications for hemodynamic support are limited...

..To evaluate whether acute kidney injury (AKI), defined as an increase in the serum creatinine level of 0.3 mg/dL or more within 48 hours, predicts outcomes of non-critically ill patients...

..3 mg/dL or greater in 48 hours, is associated with poor outcomes. The prognosis associated with an increased creatinine level, either on admission or that develops in the hospital (ie, AKI), that rapidly returns to normal is not known...

..Respect for patient autonomy is a core principle of American medicine. Informed consent is required for surgical procedures and blood transfusions but not for most medical treatments of hospitalized patients...

..Institution of a rapid response team (RRT) improves patients' quality of death (QOD)...

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..A majority of patients do not want to have invasive procedures without first giving their informed consent...

..These data suggest substantial differences of patient, physician, and family member understanding of living wills. Living wills did not reflect fully patients' expectations of receiving (or not receiving) life-sustaining modalities...

..Since this effect has also been noted following benzodiazepine infusion, the clinician should consider the patient's "sedation history" when using RSBI to guide weaning decisions...

..Only a minority drafted advance directives during hospitalization. Larger studies that include patients at other centers are required to determine whether these findings are reproducible and whether this approach is clinically feasible...