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[现代外科重症监护医学的局限性]

[Limitations of modern surgical intensive care medicine].

作者信息

Muhl E

机构信息

Sektion interdisziplinäre operative Intensivmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland,

出版信息

Chirurg. 2014 Mar;85(3):198-202. doi: 10.1007/s00104-013-2600-2.

Abstract

The attitude of humility in the context of surgical intensive care medicine incorporates a serving attitude towards the patient and the recognition of limitations in intensive care medicine. Limitations are set in the indications for intensive care medicine, in that which is medically possible and reasonable as well as ethically by the will of the patient which is binding for physicians. Furthermore, there are limitations due to available resources, due to the personal knowledge and abilities of the physician and the intensive care treatment team and due to the equipment in the intensive care ward. It is absolutely necessary to recognize and avoid futile care because this involves the use of resources which will be lost for the care of other patients who would profit from intensive care. The formal difficulties in the definition and determination of futile care are discussed.

摘要

在外科重症医学背景下,谦逊的态度包括对患者的服务态度以及对重症医学局限性的认识。重症医学的局限性体现在其适用指征方面,包括医学上可行且合理的情况,以及患者意愿在伦理上对医生具有约束力的情况。此外,还存在因可用资源、医生及重症治疗团队的个人知识与能力以及重症监护病房的设备所导致的局限性。认识并避免无效治疗绝对必要,因为这涉及资源的使用,而这些资源本可用于其他能从重症治疗中获益的患者的治疗。文中讨论了无效治疗定义和判定方面的形式困难。

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