IMPORTANCE End-of-life decisions occur daily in intensive care units (ICUs) around the world, and these practices could change over time.OBJECTIVE To determine the changes in end-of-life practices in European ICUs after 16 years. DESIGN, SETTING, AND PARTICIPANTS Ethicus-2 was a prospective observational study of 22 European ICUs previously included in the Ethicus-1 study (1999)(2000). During a self-selected continuous 6-month period at each ICU, consecutive patients who died or had any limitation of life-sustaining therapy from September 2015 until October 2016 were included. Patients were followed up until death or until 2 months after the first treatment limitation decision.

Measurement to understand our current performance and where we can improve is an essential component of ensuring that care is safe and effective for our patients. Most clinicians are familiar with audit, 1 and indeed, anaesthetists in the UK have used this technique very effectively, especially with the Royal College of Anaesthetists' National Audit Projects (NAPs) 2 3 and National Emergency Laparotomy Audit. 4 However, many of us have been taught very little about other ways to measure for improvement, such as the use of sampling, the use of run charts and statistical process control charts, the understanding of unwanted variation, and the requirements to interrogate and analyse large databases.

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Increase in the number of TUNEL positive cells in I/R group compared to sham and I/RþHFD groups. I/RþATA and I/RþATC groups showed significantly less apoptotic cells (p o0,01). Conclusion. These results showed that decrease in ACh induced contraction due to I/R was reversed in both ATC and ATA groups and that AT treatment decreased intestinal injury during reperfusion by the oxidative stress. Histological findings showed number of IL8 and TUNEL (þ) cells decreased after AT treatment of I/R. Compared to ATA; ATC treatment showed better protection against I/R. REFERENCE Campos VF, et al: Atenolol