Current opinion in critical care
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Uncertainty surrounding medical decision-making is particularly important during end-of-life decision-making. Doubts about the patient's best interests and prognostic accuracy may lead to conflict. ⋯ The implications of this review are that doctors should not avoid discussing uncertainty in end-of-life conversations and the article provides some recommendations for minimizing conflict arising from end-of-life discussion.
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To review the recent observational studies reporting the role of the rapid response team (RRT) in end-of-life care (EOLC) planning for hospitalized patients. ⋯ Up to one-third of RRT calls involve patients at the end of their life. Better understanding of the features of these patients may guide improved advance care and EOLC planning for hospitalized patients.
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Curr Opin Crit Care · Dec 2013
ReviewEvolving practices in critical care and their influence on acute kidney injury.
This review highlights the principal advances in critical care over the past year, and discusses the impact of these advances on the diagnosis and management of acute kidney injury (AKI). ⋯ The incidence of AKI appears to be increasing, and despite advances in the provision of critical care and renal replacement therapies, there has been little improvement in its associated morbidity and mortality. Nonetheless, recent advances in critical care will impact the diagnosis and management of AKI, as well as shape the future research agenda. Continued work in the fields of critical care and nephrology will undoubtedly be centered on improved biomarkers for the detection of AKI, specific therapies to mitigate or reverse AKI, and techniques to prevent the development of AKI in the critically ill population.