Articles: intensive-care-units.
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Critical care medicine · Nov 1993
Modes of death in the pediatric intensive care unit: withdrawal and limitation of supportive care.
To determine the frequency of withdrawal or limitation of supportive care for children dying in a pediatric intensive care unit (ICU). ⋯ In a large, multidisciplinary pediatric ICU, the most common mode of death was active withdrawal of support. In addition, more than half (173/300, 58%) of children dying in the pediatric ICU underwent either active withdrawal or limitation (do-not-resuscitate status) of supportive care.
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Do-not-resuscitate (DNR) orders have been espoused for the enhancement of patient autonomy, avoidance of futile medical intervention, and cost containment. Outcomes of cardiopulmonary resuscitation (CPR) in the intensive care setting have been dismal, with few patients surviving to discharge. This study compares patients who died in medical and surgical ICUs in a DNR status with those who died after attempted CPR. ⋯ Among patients dying in the medical and surgical ICUs in the authors' institution, only age and level of consciousness discriminated patients who died in a DNR status from those who died after attempted CPR.
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Family needs during the critical care experience of an adult member was the focus of this descriptive exploratory study conducted with 94 family members. The study describes the perceived needs of family members during the first 18 to 24 hours after admission of a patient to the critical care unit. The article further identifies the order in which the family perceived those needs to be met 36 to 48 hours after admission of that patient. ⋯ Items with which the family strongly agreed are discussed. The correlation between the CCFNI and the NMI is explicated. Also, the unusual finding of an inverse relationship between education and comfort/support statements is presented.