When less is more in the intensive care unit; lessons learned.
In parallel to technological advances in late twentieth century, medical diagnostics and therapeutic options greatly improved. A surge of evidence-based research in intensive care medicine provided additional opportunities and the "best" medical practice has been changing rapidly. However, the primary focus of Hippocrates: "Primum non nocere" (first do no harm) is often neglected at the bedside. It became apparent that lesser intervention in the ICU may actually mean more for the patient. Multiple examples of the concept "when less is more in the ICU" are described here in an ABC format. Critical care providers have an obligation to keenly and closely follow the results of new investigative studies and to carefully incorporate those into our practice. However, they have to be sensitive to individual circumstances, patient and family preferences, and avoidance of harm.
Festic
Emir
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Mayo Clinic, Jacksonville, FL, USA.
Gajic
Ognjen
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D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D001803:Blood Transfusion; D019317:Evidence-Based Medicine; D005440:Fluid Therapy; D006801:Humans; D007362:Intensive Care Units; D011486:Protein C / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012128:Respiratory Distress Syndrome / Q000628:therapy; D012772:Shock, Septic / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D001786:Blood Glucose; D011486:Protein C; D011994:Recombinant Proteins; C421124:drotrecogin alfa activated