[Death in an intensive care unit. Influence of life support withholding and withdrawal].
The influence of life support withholding and withdrawal on the deaths which occurred in an Intensive Care Unit (ICU) over a period of 32 months was analysed. Of 2640 patients admitted in ICU, one of the following five mutually exclusive categories was registered on the 548 patients who died: (i) complete treatment; (ii) complete treatment with non-resuscitation order (NRO); (iii) withholding of life-sustaining treatment; (iv) withdrawal of life-sustaining treatment; and (v) brain death. There was therapeutic limitation of life support in 45.6% of cases (n = 250), with an important majority of withholding (NRO and withholding) in 32.6% of cases, in comparison to withdrawal of life support (8.2% of cases). The comparative analysis with other statistic information suggests the existence of a similar global therapeutic limitation mean in communities with similar cultural background, even if there is a lower influence of life support withdrawal (8.2%) when compared to other countries regardless of their attitude towards the need to establish different degrees of control over technological resources applied to the critically ill. Further research should analyze the influence that moral perception of withdrawal as inconvenient in our society, has over our findings.
Gherardi
Carlos
C
División Terapia Intensiva, Hospital de Clínicas José de San Martin, Facultad de Medicina, Universidad de Buenos Aires, Argentina. carlosgherardi@speedy.com.ar
Chaves
Miguel
M
Capdevila
Abelardo
A
Tavella
Margarita
M
Sarquis
Sergio
S
Irrazabal
Célica
C
D000368:Aged; D001118:Argentina / Q000453:epidemiology; D003657:Decision Making; D005066:Euthanasia, Passive / Q000941:ethics; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008020:Life Support Care / Q000941:ethics* / Q000706:statistics & numerical data; D013727:Terminal Care / Q000523:psychology / Q000706:statistics & numerical data; D028761:Withholding Treatment / Q000941:ethics* / Q000706:statistics & numerical data