Ian Seppelt: ICU in Review

947 views
826 views

Published on

Seppelt ranges over a year of fraudulent behaviour, reviews, and news in intensive care.

Published in: Health & Medicine, Spiritual
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
947
On SlideShare
0
From Embeds
0
Number of Embeds
345
Actions
Shares
0
Downloads
13
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Ian Seppelt: ICU in Review

  1. 1. “Less is More” Advances in Intensive Care in 2012 Dr Ian Seppelt Dept of Intensive Care Medicine, Nepean Hospital, and George Institute for Global Health,
  2. 2. A personal view of 2012 1. New intensive care literature and publications 2. New approaches to research methodology 3. New advances in (lack of) research ethics
  3. 3. A personal view of 2012 1. New intensive care literature and publications 2. New approaches to research methodology 3. New advances in (lack of) research ethics Less is more – Don’t just do something, stand there!
  4. 4. A personal view of 2012 1. New intensive care literature and publications 2. New approaches to research methodology 3. New advances in (lack of) research ethics Less is more – Don’t just do something, stand there! Law 13: The delivery of good medical care is to do as much Nothing as possible – The Fat Man
  5. 5. Perner: New Engl J Med 2012
  6. 6. Perner: New Engl J Med 2012
  7. 7. Perner: New Engl J Med 2012
  8. 8. Perner: New Engl J Med 2012
  9. 9. Updated systematic review: mortality Gattas: Under review
  10. 10. Updated systematic review: RRT Gattas: Under review
  11. 11. `
  12. 12. `
  13. 13. Research Fraud - Joachim Boldt German Medical Board Issues Sweeping Findings in Boldt Case Ninety studies implicated in probe, might require retraction by Adam Marcus Unglaublich is the German word for unbelievable, and it's an apt description for the latest development in the case of Joachim Boldt,  MD, PhD. Dr. Boldt, a prominent German anesthesiologist, has been at the center of a research and publishing scandal since last October, when the journal Anesthesia & Analgesia retracted a 2009 article of his over concerns of data manipulation.
  14. 14. 2012 – A new record
  15. 15. 2012 – A new record
  16. 16. 2012 – A new record
  17. 17. 2012 – A new record The top 4 clinical research frauds are all anaesthetists, intensivists or perioperative physicians
  18. 18. 2012 – A new record The top 4 clinical research frauds are all anaesthetists, intensivists or perioperative physicians
  19. 19. 2012 – A new record The top 4 clinical research frauds are all anaesthetists, intensivists or perioperative physicians 1. YoshitakaFuji
  20. 20. Research Integrity
  21. 21. Research Integrity
  22. 22. Research Integrity 1. CHEST – Prespecified and published protocol and statistical analysis plan – Should now be standard
  23. 23. Research Integrity 1. CHEST – Prespecified and published protocol and statistical analysis plan – Should now be standard 2. 6S – Writing committee blinded until after results section and
  24. 24. Research Integrity 1. CHEST – Prespecified and published protocol and statistical analysis plan – Should now be standard 2. 6S – Writing committee blinded until after results section and
  25. 25. Research Integrity 1. CHEST – Prespecified and published protocol and statistical analysis plan – Should now be standard 2. 6S – Writing committee blinded until after results section and
  26. 26. Where next? Choice of fluid?
  27. 27. Where next? Choice of fluid?
  28. 28. NHMRC funding announced Oct 18th, 2012 $2,384,173.35 Where next? Fluid restriction?
  29. 29. ARDS
  30. 30. ARDS
  31. 31. Results
  32. 32. Results
  33. 33. Nutrition in ICU
  34. 34. Nutrition in ICU 1.Core business of critical medicine
  35. 35. Nutrition in ICU 1.Core business of critical medicine 2.We consistently deliver 2/3 of (prescribed) target nutrition in first few days, up to 80-90% by a week – Are we just no good at it? – Or does it matter?
  36. 36. Nutrition in ICU 1.Core business of critical medicine 2.We consistently deliver 2/3 of (prescribed) target nutrition in first few days, up to 80-90% by a week – Are we just no good at it? – Or does it matter? 3.Targets of nutrition have never been validated in the critically ill – Anorexia and catabolism is a normal adaptive stress response – Schofield and Harris-Benedict purely empirical guesswork – Even calorimetry gives an energy consumption
  37. 37. Nutrition in ICU
  38. 38. Nutrition in ICU
  39. 39. Nutrition in ICU
  40. 40. Nutrition in ICU
  41. 41. Nutrition – are the endpoints all wrong?
  42. 42. Nutrition – are the endpoints all wrong?
  43. 43. Nutrition – are the endpoints all wrong?
  44. 44. Nutrition – are the endpoints all wrong?
  45. 45. Traumatic Brain Injury
  46. 46. Imaging and clinical examination
  47. 47. Emerging infectious diseases
  48. 48. Emerging infectious diseases
  49. 49. Emerging infectious diseases
  50. 50. Novel research responses
  51. 51. Novel research responses
  52. 52. Novel research responses
  53. 53. seppelt@med.usyd.edu.au Questions ?

×