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Internist (Berl). 2017 Jun;58(6):550-555. doi: 10.1007/s00108-017-0250-z.

[Choosing wisely recommendations in intensive care medicine].

[Article in German]

Author information

1
Internistische Intensivstation, Department für Innere Medizin, Universitätsklinikum Tübingen, Tübingen, Deutschland.
2
Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
3
Innere Medizin, St.-Antonius-Hospital, Eschweiler, Deutschland.
4
Kliniken der Stadt Köln gGmbH, Köln, Deutschland.
5
Klinik für Internistische Intensiv- und Notfallmedizin und Klinische Infektiologie, Klinikum Barnim GmbH, Werner-Forßmann-Krankenhaus, Eberswalde, Deutschland.
6
Universitäts-Notfallzentrum, Universitätsklinikum, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
7
Nephrologie und Hypertensiologie, Klinikum Nürnberg Süd, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nürnberg, Deutschland.
8
Arbeitsbereich Notfallmedizin/Rettungsstellen/CPU, Campus Virchow-Klinikum und Charité Mitte, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13363, Berlin, Deutschland. martin.moeckel@charite.de.

Abstract

Intensive care medicine is an important and integral part of internal medicine. Modern intensive care medicine permits survival of many patients with severe and life-threatening internal diseases in acute situations. Decisive for therapeutic success is often not the application of complicated and expensive medical technologies, but rather the rapid diagnosis and identification of core issues, with immediate and competent initiation of standard treatment regimens. An adequately staffed, well-organized interprofessional team is of central importance. With the application of standard therapies, it has been increasingly demonstrated that "less is more", and that personalized treatment concepts are better than aggressive strategies with higher therapeutic goals. In accordance with the Choosing wisely recommendations of the American societies for intensive care medicine, the extended board of the Deutsche Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN) has formulated five positive and five negative recommendations reflecting these principles. The current paper is an updated version of the manuscript originally published in the Deutsches Ärzteblatt. When applying these recommendations, it is important to consider that intensive care patients are very complex; therefore, the applicability of these principles must be assessed on an individual basis and, where necessary, modified appropriately.

KEYWORDS:

Antibacterial agents; Deep sedation; Ethics; Noninvasive ventilation; Sepsis

PMID:
28488056
DOI:
10.1007/s00108-017-0250-z
[Indexed for MEDLINE]

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