• Intensive care medicine · Nov 2001

    Multicenter Study

    Withdrawing and withholding life support in the intensive care unit: a Spanish prospective multi-centre observational study.

    • A Esteban, F Gordo, J F Solsona, I Alía, J Caballero, C Bouza, J Alcalá-Zamora, D J Cook, J M Sanchez, R Abizanda, G Miró, M J Fernández Del Cabo, E de Miguel, J A Santos, and B Balerdi.
    • Hospital Universitario de Getafe, Carretera de Toledo Km 12,500, Getafe 28905, Madrid, Spain. aesteban@hug.es
    • Intensive Care Med. 2001 Nov 1;27(11):1744-9.

    ObjectiveTo determine how frequently life support is withheld or withdrawn from adult critically ill patients, and how physicians and patients families agree on the decision regarding the limitation of life support.DesignProspective multi-centre cohort study.SettingSix adult medical-surgical Spanish intensive care units (ICUs).Patients And ParticipantsThree thousand four hundred ninety-eight consecutive patients admitted to six ICUs were enrolled.Measurements And ResultsData collected included age, sex, SAPS II score on admission and within 24 h of the decision to limit treatment, length of ICU stay, outcome at ICU discharge, cause and mode of death, time to death after the decision to withhold or withdraw life support, consultation and agreement with patient's family regarding withholding or withdrawal, and the modalities of therapies withdrawn or withheld. Two hundred twenty-six (6.6%) of 3,498 patients had therapy withheld or withdrawn and 221 of them died in the ICU. Age, SAPS II and length of ICU stay were significantly higher in patients dying patients who had therapy withheld or withdrawn than in patients dying despite active treatment. The proposal to withhold or withdraw life support was initiated by physicians in 210 (92.9%) of 226 patients and by the family in the remaining cases. The patient's family was not involved in the decision to withhold or withdraw life support therapy in 64 (28.3%) of 226 cases. Only 21 (9%) patients had expressed their wish to decline life-prolonging therapy prior to ICU admission.ConclusionsThe withholding and withdrawing of treatment was frequent in critically ill patients and was initiated primarily by physicians.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…