Seven unconfirmed ideas to improve future ICU practice.
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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.
SubjectAdaptive clinical trials
Ventilator-induced lung injury
Published Version (Please cite this version)10.1186/s13054-017-1904-x
Publication InfoDe Backer, D; Ince, C; Marini, JJ; Singer, M; Van Haren, F; Westphal, M; & Wischmeyer, Paul Edmund (2017). Seven unconfirmed ideas to improve future ICU practice. Crit Care, 21(Suppl 3). pp. 315. 10.1186/s13054-017-1904-x. Retrieved from http://hdl.handle.net/10161/15998.
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Professor of Anesthesiology
Paul Wischmeyer M.D. is a Perioperative physician who specializes in enhancing preparation and recovery from surgery and critical care. Specifically, at Duke he practices on the Critical Care and Nutrition clinical teams. He serves as the Director of Perioperative Research for the Duke Clinical Research Institute and Associate Vice Chair for Clinical Research in the Dept. of Anesthesiology. He also serves as the Director of the Nutrition Support Team at Duke. Dr. Wischmeyer e