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  1. Limiting life support : Experiences with a special protocol.

    Article - En anglais

    Background 

    Different aspects of withholding or withdrawal of life-sustaining treatment have been described in the literature.

    However, there are few descriptions of local policies or protocols regarding the limiting of life support.

    The present study describes the pattern of limiting life support in a Scandinavian intensive care unit (ICU) and the experience with a special protocol for such decisions.

    Method 

    Prospective study of decisions to limit life support in the ICU of a tertiary referral hospital during 1 year using a special protocol and medical records.

    Results 

    A decision to limit life support was documented in the special protocol in 61/1008 (6%) of the patients and in 39/79 (49%) of the patients dying in the ICU.

    Poor prognosis and failure to respond to treatment were the most common reasons for foregoing life-sustaining treatment.

    Of the 61 patients with a special protocol, 7 survived more than 3 months.

    The decision was altered for 5 patients towards additional limitations and for 4 patients towards fewer or no limitations.

    Conclusion 

    Decisions to limit life support in the ICU are common.

    There is a substantial survival rate.

    A structured clinical protocol can be used for continuous follow-up of decisions and the decision-making process.

    Mots-clés Pascal : Réanimation cardiocirculatoire, Soin intensif, Ethique, Prise décision, Pronostic, Homme, Fréquence, Unité soin intensif, Procédure, Communication information, Suède, Europe, Hôpital

    Mots-clés Pascal anglais : Intensive cardiocirculatory care, Intensive care, Ethics, Decision making, Prognosis, Human, Frequency, Intensive care unit, Procedure, Information communication, Sweden, Europe, Hospital

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0116255

    Code Inist : 002B27B14C. Création : 22/06/1998.