Limitation of life support: frequency and practice in a Hong Kong intensive care unit.
OBJECTIVE
To examine the frequency and the decision-making processes involved in limiting (withdrawing and withholding) life support therapy in critically ill Chinese patients in the intensive care unit.


METHODS
Prospective survey of patients who had life support limited between April 1997 and March 1999.


METHODS
Medical and surgical intensive care unit of a teaching hospital.


METHODS
All patients admitted to the intensive care unit of the Prince of Wales Hospital who subsequently died and/or had life support limited. Brain-dead patients were excluded from analysis.


METHODS
None.


RESULTS
Of 490 patients who died in the intensive care unit, limitation of life support occurred in 288 (58.8%). Relatives or patients requested limitation of life support in 32 cases (11%). The family and/or patient concurred with limitation of life support in 273 occasions (95%). Therapy was withheld in 30.8% and withdrawn in 28.0% of deaths. Therapy limited included inotropes, additional oxygen, and renal replacement therapy.


CONCLUSIONS
Limitation of therapy in dying Chinese patients occurs frequently in intensive care patients, and both patients and relatives concur with medical decisions to limit therapy in these patients. Withholding therapy rather than withdrawing therapy occurs more frequently than in Western populations.
Buckley
Thomas A
TA
Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Joynt
Gavin M
GM
Tan
Peggy Y H
PY
Cheng
Claudia A Y
CA
Yap
Florence H Y
FH
D005260:Female; D006723:Hong Kong; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008020:Life Support Care / Q000941:ethics / Q000379:methods* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies