title: [Medical futility and respiratory failure: a prospective cohort study].
abstract: OBJECTIVE
  Currently, the reformulation of intensive care goals, often shifting from the search for a cure to offering comfort, has become more and more necessary. The intensivist is frequently confronted with the decision to suspend or not offer a specific therapy, despite its availability. The objective of this study was to estimate the developing risk of probability of death for individual ICU patients with respiratory failure, identify which life-sustaining therapies were administered, time of internment and outcome. Compare the death outcome in relation to UNICAMP II and APACHE II models, as well as verify if the life-sustaining therapies may be limited or suspended.
  
  
  METHODS
  It is the observational, prospective cohort study of 150 patients with respiratory failure confined to the intensive care unit. Statistical analysis was carried out using Generalized Linear Models.
  
  
  RESULTS
  Age, sex, race or morbidity did not reveal statistical significance in predicting outcome. This prediction was confirmed more accurately by means of changes in the individual prognostic index of death probability during the first seven days of ICU internment. A 10% worsening prognosis in patients who presented initial death risk of 70% to 80%, utilizing the UNICAMP II Model, showed a specificity of 97.4% - 98.6%.
  
  
  CONCLUSIONS
  Prognostic changes in patients during the first seven days of ICU internment are of great aid, from an objective point of view, for ethical decision-making in relation to not-offering new life-sustaining therapies.
authors.affiliation: UCPel.
authors.forename: Cristiano Corrêa
authors.initials: CC
authors.lastname: Batista
authors.affiliation: PUCRS.
authors.forename: Maurício Alberto
authors.initials: MA
authors.lastname: Goldbaum Júnior
authors.affiliation: PUCRS.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Sztiler
authors.affiliation: UFRGS/PUCRS.
authors.forename: José Roberto
authors.initials: JR
authors.lastname: Goldim
authors.affiliation: PUCRS.
authors.forename: Carlos Cezar
authors.initials: CC
authors.lastname: Fritscher