End-of-Life Practices in European Intensive Care Units

摘要: Context While the adoption of practice guidelines is standardizing many aspects patient care, ethical dilemmas are occurring because forgoing life-sustaining therapies in intensive care and dealt with diverse ways between different countries cultures. Objectives To determine frequency types actual end-of-life practices European units (ICUs) to analyze similarities differences. Design Setting A prospective, observational study ICUs. Participants Consecutive patients who died or had any limitation therapy. Intervention Prospectively defined 37 ICUs 17 were studied from January 1, 1999, June 30, 2000. Main Outcome Measures Comparison analysis frequencies patterns by geographic regions professionals. Results Of 31417 admitted ICUs, 4248 (13.5%) a these, 3086 (72.6%) limitations treatments (10% admissions). Substantial intercountry variability was found manner dying: unsuccessful cardiopulmonary resuscitation 20% (range, 5%-48%), brain death 8% 0%-15%), withholding therapy 38% 16%-70%), withdrawing 33% 5%-69%), active shortening dying process 2% 0%-19%). Shortening reported 7 countries. Doses opioids benzodiazepines for same range as those used symptom relief previous studies. Limitation vs continuation associated age, acute chronic diagnoses, number days ICU, region, religion (P<.001). Conclusion The limiting treatment common variable. Limitations ICU stay, religious factors. Although rare, clarity intended relieve pain suffering shorten may be lacking.