• Ernest van Veen, Mathieu van der Jagt, Giuseppe Citerio, Nino Stocchetti, Jelle L Epker, Diederik Gommers, Lex Burdorf, David K Menon, Maas Andrew I R AIR Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium. Electronic address: andrew.Maas@uza.be., Hester F Lingsma, Kompanje Erwin J O EJO Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Medical Ethics and Philosophy of Medicin, and CENTER-TBI investigators and participants.
• Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: e.vanveen.1@erasmusmc.nl.
• J Crit Care. 2020 Aug 1; 58: 78-88.

PurposeWe aimed to study variation regarding specific end-of-life (EoL) practices in the intensive care unit (ICU) in traumatic brain injury (TBI) patients.Materials And MethodsRespondents from 67 hospitals participating in The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study completed several questionnaires on management of TBI patients.ResultsIn 60% of the centers, ≤50% of all patients with severe neurological damage dying in the ICU, die after withdrawal of life-sustaining measures (LSM). The decision to withhold/withdraw LSM was made following multidisciplinary consensus in every center. Legal representatives/relatives played a role in the decision-making process in 81% of the centers. In 82% of the centers, age played a role in the decision to withhold/withdraw LSM. Furthermore, palliative therapy was initiated in 79% of the centers after the decision to withdraw LSM was made. Last, withholding/withdrawing LSM was, generally, more often considered after more time had passed, in a patient with TBI, who remained in a very poor prognostic condition.ConclusionWe found variation regarding EoL practices in TBI patients. These results provide insight into variability regarding important issues pertaining to EoL practices in TBI, which can be useful to stimulate discussions on EoL practices, comparative effectiveness research, and, ultimately, development of recommendations.Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

17 keywords...

hide…