Seven unconfirmed ideas to improve future ICU practice

Date

2017

Authors

Marini, John J
De Backer, Daniel
Ince, Can
Singer, Mervyn
Van Haren, Frank
Westphal, Martin
Wischmeyer, Paul

Journal Title

Journal ISSN

Volume Title

Publisher

BioMed Central

Abstract

With imprecise definitions, inexact measurement tools, and flawed study execution, our clinical science often lags behind bedside experience and simply documents what appear to be the apparent faults or validity of ongoing practices. These impressions are later confirmed, modified, or overturned by the results of the next trial. On the other hand, insights that stem from the intuitions of experienced clinicians, scientists and educators-while often neglected-help place current thinking into proper perspective and occasionally point the way toward formulating novel hypotheses that direct future research. Both streams of information and opinion contribute to progress. In this paper we present a wide-ranging set of unproven 'out of the mainstream' ideas of our FCCM faculty, each with a defensible rationale and holding clear implications for altering bedside management. Each proposition was designed deliberately to be provocative so as to raise awareness, stimulate new thinking and initiate lively dialog.

Description

Keywords

Microcirculation, Resuscitation, Shock, Sepsis, Ventilator-induced lung injury, Personalized medicine, Melatonin, Adaptive clinical trials, Metabolic monitoring

Citation

Source

Critical Care

Type

Journal article

Book Title

Entity type

Access Statement

Open Access

License Rights

Creative Commons Attribution 4.0 International License

DOI

10.1186/s13054-017-1904-x

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