Marini John J, Rubenfeld Gordon
University of Minnesota, USA.
Crit Care. 2002 Feb;6(1):15-7. doi: 10.1186/cc1447. Epub 2002 Jan 17.
Critical care medicine is a relatively new specialty and as such there is not a great deal of accumulated data to allow clinicians to practice 'evidence-based medicine' in all situations they encounter. When evidence does exist, intensivists may choose not to follow it based on 'gut feelings' or their own interpretation of how the data apply to their patient. It is perhaps not surprising that these latter events occur given that intensivists are often literally fighting for their patient's lives. Prone positioning evokes a large emotional response from many intensivists. Despite accumulating data there appears to be two camps of clinicians: those who strongly believe in the therapy, and those who want more data. The emotion and rationale for the mindset of the two camps is evident in this issue of . With compelling arguments on both sides of the fence, it is apparent that this debate is far from over. The authors of this pro/con debate, which is based on a clinical scenario, first describe their position and then respond to their opponent's position.
重症医学是一个相对较新的专业领域，因此，没有大量的累积数据可供临床医生在他们遇到的所有情况下实践“循证医学”。当确实存在证据时，重症监护医生可能会基于“直觉”或他们自己对数据如何应用于其患者的解读而选择不遵循该证据。考虑到重症监护医生常常实实在在地为患者的生命而战，后一种情况的发生或许并不令人惊讶。俯卧位通气在许多重症监护医生中引发了强烈的情绪反应。尽管数据不断积累，但临床医生似乎分为两个阵营：那些坚信这种治疗方法的人，以及那些需要更多数据的人。两个阵营的思维方式所蕴含的情感和基本原理在本期杂志中显而易见。由于争论双方都有令人信服的论据，显然这场辩论远未结束。这场基于一个临床病例的正反观点辩论的作者们，首先阐述他们的立场，然后回应对方的立场。
