Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
A RETROSPECTIVE REVIEW OF A LARGE COHORT OF PATIENTS UNDERGOING THE PROCESS OF WITHHOLDING OR WITHDRAWAL OF LIFE-SUPPORT
Autore:
KEENAN SP; BUSCHE KD; CHEN LM; MCCARTHY L; INMAN KJ; SIBBALD WJ;
Indirizzi:
LONDON HLTH SCI CTR,DEPT MED,DIV CRIT CARE MED,VICTORIA CAMPUS,375 S ST LONDON ON N6A 4G5 CANADA VICTORIA HOSP,RICHARD IVEY CRIT CARE TRAUMA CTR LONDON ON N6A 4G5 CANADA UNIV WESTERN ONTARIO,SCH MED LONDON ON CANADA
Titolo Testata:
Critical care medicine
fascicolo: 8, volume: 25, anno: 1997,
pagine: 1324 - 1331
SICI:
0090-3493(1997)25:8<1324:ARROAL>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
CRITICALLY ILL PATIENTS; INTENSIVE-CARE UNIT; SUSTAINING TREATMENT; PRACTICE GUIDELINES; PHYSICIANS; CONSENSUS; DECISIONS;
Keywords:
LIFE-SUPPORT CARE; CRITICAL ILLNESS; TERMINAL ILLNESS; DECISION MAKING; WITHHOLDING; WITHDRAWING; TERMINAL CARE; CRITICAL CARE; INTENSIVE CARE; ADULT; EUTHANASIA, PASSIVE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
S.P. Keenan et al., "A RETROSPECTIVE REVIEW OF A LARGE COHORT OF PATIENTS UNDERGOING THE PROCESS OF WITHHOLDING OR WITHDRAWAL OF LIFE-SUPPORT", Critical care medicine, 25(8), 1997, pp. 1324-1331

Abstract

Objectives: To determine the proportion of patients who died as a result of the withdrawal or withholding of life support (WD/ WHLS) in theintensive care units (ICUs) of three teaching hospitals and to describe the process involved by determining: a) why the decision was made to withdraw support (WDLS); b) when WDLS took place; and c) how the WDLS process was conducted. Design: Retrospective cohort study. Setting: Three university-affiliated ICUs. Patients: Four hundred nineteen patients who died in one of three academic, tertiary care ICUs over a l-yrperiod. Interventions: Retrospective chart review, Data collected in eluded age, gender, admitting diagnoses, comorbid disease, Acute Physiology and Chronic Health Evaluation II score, and mode of death (braindeath, death due to withholding of life support, death due to WDLS, or death despite ongoing therapy), For those patients dying due to WDLS, the reason for WDLS, person initiating discussion, timing of WDLS, degree of organ dysfunction, order of withdrawal of life support modalities, and the use of sedatives and analgesics were recorded. Measurements and Main Results: Seventy percent of patients died by WD/WHLS and 8.4% were brain dead, Patients undergoing WD/WHLS were older and had alonger length of stay than patients dying from other causes, Poor prognosis was the most common reason given for WDLS, reflected by significant organ dysfunction at the time of WDLS, Future quality of life wasa less frequently cited reason, Most patients undergoing WDLS did so early in their ICU stay, although time to WDLS appeared to reflect diagnostic group, Few meetings occurred before WDLS and death occurred soon after initiating WDLS, There was a preference of withdrawing mechanical ventilation last and large amounts of morphine (mean 21 +/- 33 [SD] mg/hr) and benzodiazepines (mean 8.6 +/- 11 mg/hr) were used, Little variability in practice was apparent among the studied ICUs. Conclusions: Similar to other studies, WD/WHLS was the most common cause of death in academic ICUs and poor patient prognosis was considered the most important factor in deciding on WDLS, However, in contrast to otherstudies, future quality of life was nor as frequently cited a reason for WDLS and larger amounts of morphine were used during WDLS, These discrepancies suggest areas for potential future research.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/09/20 alle ore 08:40:32