Evidence based critical care medicine:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1998
|
| Schriftenreihe: | Critical care clinics
14,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 353 - 562 Ill., graph. Darst. |
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Datensatz im Suchindex
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| adam_text | EVIDENCE BASED CRITICAL CARE MEDICINE
CONTENTS
Preface xi
Deborah J. Cook and Mitchell M. Levy
Evidence Based Medicine: A Tool for Enhancing Critical
Care Practice 353
Deborah J. Cook and Mitchell M. Levy
Evidence based medicine (EBM) involves caring for patients by
explicitly integrating clinical research evidence with pathophysio
logic reasoning, caregiver experience, and patient preferences.
EBM is a style of practice and teaching which may also help plan
future research. This article discusses the application of EBM to
critical care.
An Evidence Based Approach To Noninvasive Ventilation
in Acute Respiratory Failure 359
Sean P. Keenan and David Brake
This article reviews the literature of noninvasive positive pressure
ventilation (NPPV) in patients with acute respiratory failure. The
article divides acute respiratory failure into the categories of
primary ventilation failure and oxygenation failure, and examines
various diagnostic groups within these categories. Although the
use of NPPV for patients with acute respiratory failure of other
etiologies requires further study, the authors conclude that there
is sufficient evidence to support the use of NPPV in acute, severe
exacerbations of chronic obstructive pulmonary disease.
An Evidence Based Approach to Pressure and
Volume Limited Ventilation Strategies 373
Maureen O. Meade
Pressure and volume limited ventilation strategies represent a
topical area of interest to critical care clinicians and researchers
CRITICAL CARE CLINICS
VOLUME 14 • NUMBER 3 • JULY 1998 V
alike. Considering the current surge in publication of preliminary
results of relevant randomized trials, it is time to critically re¬
appraise the best available clinical research evidence evaluating
this intensive care unit intervention. This article reviews the valid¬
ity, results, and clinical applicability of five studies, reported in
abstracts and full journal articles, and presents a framework for
evaluating forthcoming study results.
The Efficacy of Inhaled Nitric Oxide in the Treatment of
Acute Respiratory Distress Syndrome: An Evidence Based
Medicine Approach 387
Jeffrey H. Greene and James R. Klinger
Nitric oxide is an endothelial relaxing factor. When given as
an inhalational agent in the acute respiratory distress syndrome
(ARDS), it vasodilates well ventilated areas of lung and improves
oxygenation. Nitric oxide is a highly reactive molecule with myr¬
iad biologic effects, both potentially beneficial and toxic; its use
as an inhalational agent in ARDS is experimental. This article
reviews the available studies of inhaled nitric oxide.
An Evidence Based Approach to Central Venous Catheter
Management to Prevent Cather Related Infection in
Critically 111 Patients 411
Adrienne G. Randolph
A systematic search of the literature yielded 102 randomized
controlled trials of interventions aimed at reducing central venous
catheter related infections in critically ill patients. The process of
critically appraising these trials has begun and clinicians have
performed meta analyses of the data in some areas. There are
three main components to the production of evidence based
guidelines in this area: identification of effective interventions,
comparison of the relative merit of effective interventions aimed
at the source of infection, and assessment of the applicability of
the evidence to diverse sub populations of critically ill patients.
Nutritional Support in the Critically 111 Patient: A Critical
Review of the Evidence 423
D. K. Heyland
Providing nutritional support has become a standard component
of managing critically ill patients. While many studies have docu¬
mented that providing nutritional support can change nutritional
outcomes (e.g., amino acid profile, weight gain, nitrogen balance),
data are lacking that demonstrate that nutrition actually influ¬
ences clinically important endpoints. This article systematically
reviews and critically appraises the literature, examining the rela¬
tionship between nutritional support and infectious morbidity
and mortality in the critically ill patient. In addition, evidence
based recommendations are made.
vi CONTENTS
An Evidence Based Approach to the Treatment of
Esophageal Variceal Bleeding 441
Philip S. Schoenfeld and James A. Butler
Esophageal varices are a life threatening cause of gastrointestinal
bleeding. Management includes both primary prevention of vari¬
ceal bleeding and treatment of actively bleeding varices. Evidence
from randomized controlled trials indicates that beta blockers and
nitrates may prevent the initial episode of bleeding varices.
Ample data from randomized controlled trials indicate that band
ligation is more effective than scleropathy for the treatment of
bleeding esophageal varices. Somatostatin may decrease rebleed
ing rates with or without endoscopic therapy. No effective treat¬
ment has been developed for the treatment of patients who fail
endoscopic therapy.
An Evidence Based Evaluation of the Use of Sodium
Bicarbonate During Cardiopulmonary Resuscitation 457
Mitchell M. Levy
The use of bicarbonate is rooted in three decades of clinical
experience and observational studies. For many years, bicarbon¬
ate passed the tried and true test for clinical therapies; however,
administration of sodium bicarbonate during cardiac arrest and
hypoxic acidosis has become increasingly controversial. The con¬
troversy provides an excellent opportunity to evaluate the impact
an evidence based approach might have on a common clinical
practice. Is bicarbonate efficacious in the treatment of the severe
acidosis that accompanies cardiac arrest during cardiopulmonary
resuscitation (CPR)? Are the deleterious effects of bicarbonate
clinically relevant? What is the evidence upon which a rational
decision may be based? This review evaluates and ranks the
evidence supporting the use of sodium bicarbonate in the therapy
of acidosis associated with cardiac arrest during CPR.
An Evidence Based Approach to Management of Increased
Intracranial Pressure 485
Clark H. Allen and John D. Ward
Treatment of increased intracranial pressure can be challenging in
the severely head injured patient. Many treatment regimes have
only recently been studied closely to evaluate long term outcome
and efficacy, while other regimes continue to be used without
outcome data. This article identifies methods of management of
increased intracranial pressure, explores relevant scientific studies
to support or refute treatments, and makes appropriate clinical
recommendations.
Prognosis in Anoxic and Traumatic Coma 497
John Attia and Deborah J. Cook
This article presents a systematic review of the prognostic factors
in coma caused by hypoxia and anoxia, and traumatic head
CONTENTS vii
injury. In the case of anoxic coma, poor prognosis can be deter¬
mined very accurately at the bedside by the lack of brainstem
reflexes assessed at day three post insult. Electroencephalogram
(EEG) and evoked potentials (i.e., auditory and somatosensory)
detect additional patients with poor prognosis. Clinical examina¬
tion is not as helpful in the case of traumatic coma. Evoked
potentials performed within the first week detect approximately
half of patients with a poor prognosis. EEG adds only a small
amount of prognostic information.
Interpreting and Using Clinical Trials 513
Gordon S. Doig
This article provides a framework for quickly assessing the qual¬
ity of a published clinical trial. Using numerous publications on
critical appraisal as building blocks, the author combines previous
publications with new, important concepts published more re¬
cently in the primary clinical trials literature.
Evidence Based Medicine and Cost Effectiveness Analysis 525
Donald B. Chalfin
Health care has become increasingly expensive and clinicians
have come under increased scrutiny to critically appraise the
economic impact of medical programs and interventions. To en¬
sure an equitable allocation of scarce resources and the attainment
of maximal clinical benefit, it is vital to adhere to certain basic
tenets of economic analysis and to understand the basic approach
to cost effectiveness analysis. These principles are applied to criti¬
cal care medicine and analogies are made to the methodological
rigor of evidence based medicine.
An Evidence Based Approach to Round Tables and
Consensus Conferences 539
Jean Louis Vincent and Jacques Berre
In current clinical practice, it is important to be able to evaluate
the evidence supporting each of our actions. Physicians can no
longer rely on tradition or habit; however, with the increasing
number of journals available, it is impossible for the practicing
clinician to keep abreast of all the relevant literature. One valuable
method of gathering and summarizing the latest information and
opinions is the use of round tables and consensus conferences.
Published reports of round table and consensus conference find¬
ings can be invaluable in guiding the clinician.
Some Opinions on the Future of Evidence Based Medicine 549
William J. Sibbald
Clinicians who introduced evidence based medicine (EBM) ar¬
gued for an approach to medical practice and teaching based on
viii CONTENTS
knowledge of the evidence upon which practice is founded and
on the strength of the evidence itself. This article reviews the
impetus for the design and growth of EBM, defines and examines
the paradigm of EBM, and offers some opinions on the future of
EBM in critical care.
Index 559
Subscription Information Inside back cover
CONTENTS ix
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| spelling | Evidence based critical care medicine Deborah J. Cook ... guest ed. Evidence-based critical care medicine Philadelphia [u.a.] Saunders 1998 XII S., S. 353 - 562 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Critical care clinics 14,3 Qualitätssteigerung (DE-588)4176587-4 gnd rswk-swf Qualitätssicherung (DE-588)4126457-5 gnd rswk-swf Notfallmedizin (DE-588)4042676-2 gnd rswk-swf Intensivmedizin (DE-588)4027263-1 gnd rswk-swf Medizinische Versorgung (DE-588)4038270-9 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Intensivmedizin (DE-588)4027263-1 s Medizinische Versorgung (DE-588)4038270-9 s Qualitätssicherung (DE-588)4126457-5 s DE-604 Qualitätssteigerung (DE-588)4176587-4 s Notfallmedizin (DE-588)4042676-2 s Cook, Deborah J. Sonstige oth Critical care clinics 14,3 (DE-604)BV000019838 14,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008220846&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Evidence based critical care medicine Critical care clinics Qualitätssteigerung (DE-588)4176587-4 gnd Qualitätssicherung (DE-588)4126457-5 gnd Notfallmedizin (DE-588)4042676-2 gnd Intensivmedizin (DE-588)4027263-1 gnd Medizinische Versorgung (DE-588)4038270-9 gnd |
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| title | Evidence based critical care medicine |
| title_alt | Evidence-based critical care medicine |
| title_auth | Evidence based critical care medicine |
| title_exact_search | Evidence based critical care medicine |
| title_full | Evidence based critical care medicine Deborah J. Cook ... guest ed. |
| title_fullStr | Evidence based critical care medicine Deborah J. Cook ... guest ed. |
| title_full_unstemmed | Evidence based critical care medicine Deborah J. Cook ... guest ed. |
| title_short | Evidence based critical care medicine |
| title_sort | evidence based critical care medicine |
| topic | Qualitätssteigerung (DE-588)4176587-4 gnd Qualitätssicherung (DE-588)4126457-5 gnd Notfallmedizin (DE-588)4042676-2 gnd Intensivmedizin (DE-588)4027263-1 gnd Medizinische Versorgung (DE-588)4038270-9 gnd |
| topic_facet | Qualitätssteigerung Qualitätssicherung Notfallmedizin Intensivmedizin Medizinische Versorgung Aufsatzsammlung |
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