Seven unconfirmed ideas to improve future ICU practice.
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 articleSubject
Adaptive clinical trialsMelatonin
Metabolic monitoring
Microcirculation
Personalized medicine
Resuscitation
Sepsis
Shock
Ventilator-induced lung injury
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https://hdl.handle.net/10161/15998Published Version (Please cite this version)
10.1186/s13054-017-1904-xPublication 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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Show full item recordScholars@Duke
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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