sábado, 26 de mayo de 2018

Ideas no confirmadas en UCI / ICU unconfirmed ideas.

Mayo 24, 2018. No. 3090
Siete ideas no confirmadas para mejorar la práctica futura de la UCI.
Seven unconfirmed ideas to improve future ICU practice.
Crit Care. 2017 Dec 28;21(Suppl 3):315. doi: 10.1186/s13054-017-1904-x.
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.
KEYWORDS: Adaptive clinical trials; Melatonin; Metabolic monitoring; Microcirculation; Personalized medicine; Resuscitation; Sepsis; Shock; Ventilator-induced lung injury
Algunas de nuestras ideas favoritas sin confirmar.
A few of our favorite unconfirmed ideas.
Crit Care. 2015;19 Suppl 3:S1. doi: 10.1186/cc14719. Epub 2015 Dec 18.Abstract
Medical practice is rooted in our dependence on the best available evidence from incremental scientific experimentation and rigorous clinical trials. Progress toward determining the true worth of ongoing practice or suggested innovations can be glacially slow when we insist on following the stepwise scientific pathway, and a prevailing but imperfect paradigm often proves difficult to challenge. Yet most experienced clinicians and clinical scientists harbor strong thoughts about how care could or should be improved, even if the existing evidence base is thin or lacking. One of our Future of Critical Care Medicine conference sessions encouraged sharing of novel ideas, each presented with what the speaker considers a defensible rationale. Our intent was to stimulate insightful thinking and free interchange, and perhaps to point in new directions toward lines of innovative theory and improved care of the critically ill. In what follows, a brief background outlines the rationale for each novel and deliberately provocative unconfirmed idea endorsed by the presenter.
Congresos Médicos por Especialidades en todo Mundo
Medical Congresses by Specialties around the World
Safe Anaesthesia Worldwide
Delivering safe anaesthesia to the world's poorest people
X Foro Internacional de Medicina del Dolor y Paliativa
Taller de Bloqueos guiados por Ultrasonido con el Dr. Philip Peng
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Ciudad de México, 7 al 9 de junio de 2018. 
V Congreso Internacional de Vía Aérea, EVALa, México
Junio 7-9, 2018. Guadalajara. México
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Anestesiología y Medicina del Dolor

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