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Seven unconfirmed ideas to improve future ICU practice.

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Date
2017-12-28
Authors
Marini, John J
De Backer, Daniel
Ince, Can
Singer, Mervyn
Van Haren, Frank
Westphal, Martin
Wischmeyer, Paul
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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
Journal article
Subject
Adaptive clinical trials
Melatonin
Metabolic monitoring
Microcirculation
Personalized medicine
Resuscitation
Sepsis
Shock
Ventilator-induced lung injury
Permalink
https://hdl.handle.net/10161/15998
Published Version (Please cite this version)
10.1186/s13054-017-1904-x
Publication Info
Marini, John J; De Backer, Daniel; Ince, Can; Singer, Mervyn; Van Haren, Frank; Westphal, Martin; & Wischmeyer, Paul (2017). Seven unconfirmed ideas to improve future ICU practice. Crit Care, 21(Suppl 3). pp. 315. 10.1186/s13054-017-1904-x. Retrieved from https://hdl.handle.net/10161/15998.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Wischmeyer

Paul Edmund Wischmeyer

Professor of Anesthesiology
Paul Wischmeyer M.D., EDIC, FASPEN, FCCM is a critical care, perioperative, and nutrition physician-researcher who specializes in enhancing preparation and recovery from surgery, critical care and COVID-19. He serves as a Tenured Professor of Anesthesiology and Surgery at Duke. He also serves as the Associate Vice Chair for Clinical Research in the Dept. of Anesthesiology and Director of the TPN/Nutrition Team at Duke. Dr. Wischmeyer earned his medical degree with honors at T
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