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Table 1 'We don't know': selected statements of uncertainty made by presenters at the 26th ISICEM

From: 26th International Symposium on Intensive Care and Emergency Medicine, 21–24 March 2006, Brussels, Belgium

Presenter Topic of talk Statement
Greet Van den Berghe (Leuven, Belgium) Tight Glucose Control: Insights into the Mechanisms With regard to the effect of hyperinsulinemia: 'What's going on in the critically ill? Actually, we know very little about this'
Luciano Gattinoni (Milan, Italy) ARDS 2006 'After 40 years we still do not know how to set PEEP'
Jan Bakker (Rotterdam, The Netherlands) Outreach: The Pros and Cons 'When is the ideal moment for the patient to come to the ICU? When does he or she benefit most from admission to the ICU? We don't know'
Eric Milbrandt (Pittsburgh, PA, USA) The Place of Haloperidol In the case of hypoactive delirium, 'no one really knows if treating delirium is good for those patients or not'
Jean-Francois Payen (Grenoble, France) Analgo-Sedation: Current Practices 'Everybody knows something about sedation. Pain is more complicated'
James Jackson (Nashville, TN, USA) Assessment of Cognitive Dysfunction 'What we see in the ICU we typically refer to as cognitive dysfunction. It may well transition into something permanent, but when patients are in the ICU we really don't know if that's the case or not'
Mervyn Singer (London, UK) Primum non Nocere 'When you resuscitate the patient and put on high-flow oxygen ... what harm is that engendering? We don't know'
Marco Ranieri (Turin, Italy) Do my Patients Sleep? 'I don't know if a patient with septic shock who is under an aggressive sedation protocol has any kind of sleep pattern that could be described. The fact that the patient looks asleep because of sedation does not mean that the patient is asleep'
Bernd Böttiger (Heidelberg, Germany) CPR: New European Guidelines 'It is unknown whether survival is improved with vasopressors after cardiac arrest'
Dennis Maki (Madison, WI, USA) Emerging Infectious Diseases: The Next SARS Bird flu 'has adapted to be able to infect feline species. The question is, "Will it infect humans?" And we don't know the answer to that'
Kenneth Hillman (Liverpool, Australia) How to Deal with Relatives 'We must be honest about the uncertainty' when discussing ICU survival with families. We must say, 'Look, I think this is what will happen, but we never really know'
David Menon (Cambridge, UK) The Vegetative State Chronic prolonged vegetative-state patients can have preserved cortical processing. 'What does this mean in terms of awareness? We don't know'
Derek Angus (Pittsburgh, PA, USA) Organization and Delivery of Critical Care Services in the US 'What is the value of intensive care? How well does our literature document it? ... When we start looking at articles to support this, they are scant'
  1. ARDS, acute respiratory distress syndrome; CPR, cardiopulmonary resuscitation; PEEP, positive end expiratory pressure; SARS, severe acute respiratory syndrome.