[Decision to limit or practise maximum therapeutic support in a neurosurgical intensive care unit].
OBJECTIVE
To assess the respective rates of intensive care maximalization, limitation and withdrawal practice in a neurosurgical intensive care unit.


METHODS
Prospective clinical study.


METHODS
All patients who died in the unit during the year 1994 were included in this study.


METHODS
Demographic data and medical history of these patients were collected, and treatments during the last days and the 24 hours before death were reviewed.


RESULTS
Among the 49 cases collected during the study period, 16 patients (33%) received full intensive therapy until their death. In 29 (59%), death was preceded by some limitation of treatment, and in 4 (8%) life-sustaining treatment (mechanical ventilation, vasopressor infusion) had not been undertaken.


CONCLUSIONS
This prospective study confirmed the results of several previous surveys. The medical decision to limit or to discontinue treatments is rather frequent in intensive care units. This is an illegal practice in French legislation and code of professional ethics. Recommendations by representative French medical associations on the modalities of decision making on limitation of therapy would be welcome.
Peillon
D
D
Département d'anesthésie-réanimation, hôpital neurologique, Lyon, France.
Salord
F
F
Riche
H
H
Jenoudet
M T
MT
Chacornac
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D006801:Humans; D007223:Infant; D008020:Life Support Care; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000628:therapy*; D011446:Prospective Studies; D016414:Resuscitation Orders; D012297:Right to Die