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Seven unconfirmed ideas to improve future ICU practice

Marini, JJ; De Backer, D; Ince, C; Singer, M; Van Haren, F; Westphal, M; Wischmeyer, P; (2017) Seven unconfirmed ideas to improve future ICU practice. Critical Care , 21 (Suppl 3) , Article 315. 10.1186/s13054-017-1904-x. Green open access

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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.

Type: Article
Title: Seven unconfirmed ideas to improve future ICU practice
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s13054-017-1904-x
Publisher version: https://doi.org/10.1186/s13054-017-1904-x
Language: English
Additional information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology, Life Sciences & Biomedicine, Critical Care Medicine, General & Internal Medicine, Microcirculation, Resuscitation, Shock, Sepsis, Ventilator-induced lung injury, Personalized medicine, Melatonin, Adaptive clinical trials, Metabolic monitoring, RESPIRATORY-DISTRESS-SYNDROME, SEPTIC SHOCK, CRITICALLY-ILL, SEVERE SEPSIS, NITRIC-OXIDE, LUNG INJURY, BLOOD-FLOW, MELATONIN, THERAPY, RESUSCITATION
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Experimental and Translational Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10043192
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