Abstract
The future of critical care medicine will be shaped not only by the evidence-validated foundations of science, but also by innovations based on unproven and, in many cases, untested concepts and thoughtful visions of scientists and clinicians familiar with the complex problems actually faced in clinical practice. Clinical investigations and trials often lag behind collective experience and impressions, in a well-intentioned and necessary quest to determine the fallacy or validity of ongoing practice. Progress made in this way can be painfully slow, and imperfect theory may prove difficult to challenge. On occasion, an innovative paradigm shift fostered by a novel approach can reorient the forces of academic investigation toward generating an evidence base upon which such concepts and interpretations can find scientific justification. This discussion presents a selected set of ideas to improve the future practice of critical care - each having a defensible rationale, but unconfirmed validity.
Highlights
While technical innovations and scientific experiments often lead clinical practice, at times clinical science lags behind experience and documents what appears to be the fallacy or validity of ongoing practice. Progress made in this way can be slow, and imperfect theory may prove difficult to challenge
A brief background outlines the rationale for each novel and unproven idea endorsed by the presenter
Unrecorded sounds heard through the stethoscope are evanescent, the interpretation of the nature, timing, and amplitude of breath sounds is subjective, and high variability between observers is well documented [2]
Summary
While technical innovations and scientific experiments often lead clinical practice, at times clinical science lags behind experience and documents what appears to be the fallacy or validity of ongoing practice Progress made in this way can be slow, and imperfect theory may prove difficult to challenge. What follows is a wideranging set of unproven ideas, each having a defensible rationale but unverified worth. The intent of this thoughtprovoking format is to stimulate thinking and interchange, and perhaps to point toward new directions with potential for productive research, conceptual modification, and eventual applications that could improve care of the critically ill. A brief background outlines the rationale for each novel and unproven idea endorsed by the presenter
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