University of Groningen
Rational clinical examination of the critically ill patient
Hiemstra, Bart
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2019
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Hiemstra, B. (2019). Rational clinical examination of the critically ill patient. Rijksuniversiteit Groningen.
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531658-L-st-Hiemstra 531658-L-st-Hiemstra 531658-L-st-Hiemstra 531658-L-st-Hiemstra Processed on: 23-5-2019 Processed on: 23-5-2019 Processed on: 23-5-2019 Processed on: 23-5-2019
Clinical examination is routinely used for diagnosing circulatory shock, although a physician’s educated guess of cardiac output seems to equal the flip of a coin. – This thesis
A single clinical examination provides insufficient information to accurately diagnose a low or high cardiac output. – This thesis
Clinical signs are important warning signals that a patient deteriorates, but cannot reliably indicate whether the cardiac output is insufficient, or what the underlying cause is. – This thesis A simple and easily obtainable clinical examination may better inform physicians in their clinical decision making than established prognostic risk scores. – This thesis
The validity of observational studies may increase by prospective publications of protocols and statistical analysis plans to prevent outcome reporting bias and data-driven analyses. – This thesis
The concern that important findings will remain unpublished is less worrying than a lot of accidental findings getting published. – This thesis
The choice of administering dopamine (or any inotrope) for cardiac dysfunction should be based on achieving objective haemodynamic targets, since currently no inotrope has proven beneficial effects on patient-centred outcomes. – This thesis
A handheld ultrasonography probe will become the stethoscope of the 21st century. – This thesis
If I’d had more time I would have written a shorter thesis. – Benjamin Franklin When they attack, sway like a boxer rather than go into a fight. – Christian Gluud
It is amazing what you can accomplish if you do not care who gets the credit. – Harry Truman Many of the truths that we cling to depend on our point of view. – Obi-Wan Kenobi
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Bart Hiemstra, Groningen 2019
