title: Perceptions about end of life treatment in Argentina, Brazil and Uruguay intensive care units.
abstract: OBJECTIVE
  To evaluate end-of-life procedures in intensive care units.
  
  
  METHODS
  A questionnaire was prepared by the End-of-Life Study Group of the Argentinean, Brazilian and Uruguayan Intensive Care societies, collecting data on the participants demographics, institutions and limit therapeutic effort (LTE) decision making process. During this cross sectional study, the societies multidisciplinary teams members completed the questionnaire either during scientific meetings or online. The variables were analyzed with the Chi-square test, with a p<0.05 significance level.
  
  
  RESULTS
  420 professionals completed the questionnaire. The Brazilian units had more beds, unrestricted visit was less frequent, their professionals were younger and worked more recently in intensive care units, and more non-medical professionals completed the questionnaire. Three visits daily was the more usual number of visits for the three countries. The most influencing LTE factors were prognosis, co-morbidities, and therapeutic futility. In the three countries, more than 90% of the completers had already made LTE decisions. Cardiopulmonary resuscitation, vasoactive drugs administration, dialysis and parenteral nutrition were the most suspended/refused therapies in the three countries. Suspension of mechanic ventilation was more frequent in Argentina, followed by Uruguay. Sedation and analgesia were the less suspended therapies in the three countries. Legal definement and ethical issues were mentioned as the main barriers for the LTE decision making process.
  
  
  CONCLUSIONS
  LTE decisions are frequent among the professionals working in the three countries intensive care units. We found a more proactive LTE decision making trend In Argentina, and more equity for decisions distribution in Uruguay. This difference appears to be related to the participants different ages, experiences, professional types and genders.
authors.affiliation: Associação de Medicina Intensiva Brasileira, Brasil.
authors.forename: Rachel Duarte
authors.initials: RD
authors.lastname: Moritz
authors.affiliation: Sociedade Uruguaia de Medicina Intensiva, Uruguai.
authors.forename: Alberto
authors.initials: A
authors.lastname: Deicas
authors.affiliation: Sociedade Argentina de Terapia Intensiva, Argentina.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Rossini
authors.affiliation: Associação de Medicina Intensiva Brasileira, Brasil.
authors.forename: Nilton Brandão da
authors.initials: NB
authors.lastname: Silva
authors.affiliation: Associação de Medicina Intensiva Brasileira, Brasil.
authors.forename: Patrícia Miranda do
authors.initials: PM
authors.lastname: Lago
authors.affiliation: Associação de Medicina Intensiva Brasileira, Brasil.
authors.forename: Fernando Osni
authors.initials: FO
authors.lastname: Machado