title: [Therapeutic limitation conducts in intensive care unit patients].
abstract: OBJECTIVE
  There is a growing tendency of looking for "dying with dignity", rather than to prolong death and suffering of terminal patients on intensive care units (ICU). This study aims to evaluate medical practices that suggest therapeutic limitation (TL) in patients who died in an adult ICU.
  
  
  METHODS
  A retrospective exploratory study was carried out to evaluate medical records of patients who died in a general adult ICU of a private hospital in Salvador-BA, between January and August of 2003, after at least 24 hours from the admission. The patients were classified, in relation to their deaths, in: "not responding to cardiopulmonary resuscitation", "brain death", "decision not to resuscitate" (DNR) and "withhold or withdrawal life-support measures".
  
  
  RESULTS
  Sixty seven patients were included, corresponding to 90.4% of the deaths occurred in this ICU during the referred period. The most of them (56.7%) were women and the patients mean age was 66.58 ± 17.86 years. Suggestive measures of TL were found in 59.7% of the patients, being "withhold of life-support measures" the most important (35.8%), followed by DNR (17.9%) and "withdrawal of life-support measures" (6%). The procedures most commonly omitted were use of vasoactive drugs and dialysis, while antibiotics were the most discontinued. The use of TL measures was more frequent in clinical patients.
  
  
  CONCLUSIONS
  The results of the present study suggest high frequencies of medical conducts suggestive of TL in a general ICU in Northeast of Brazil. Therapeutic methods that could cause discomfort or suffering to the patients, as nutrition, sedation and analgesia, were rarely omitted or discontinued.
authors.affiliation: Faculdade de Medicina da Bahia, UFBA.
authors.forename: Almir Galvão Vieira
authors.initials: AG
authors.lastname: Bitencourt
authors.affiliation: UTI Geral, Hospital Português, Salvador, BA.
authors.forename: Maira Pereira
authors.initials: MP
authors.lastname: Dantas
authors.affiliation: Escola Bahiana de Medicina e Saúde Pública.
authors.forename: Flávia Branco Cerqueira Serra
authors.initials: FB
authors.lastname: Neves
authors.affiliation: Faculdade de Medicina da Bahia, UFBA.
authors.forename: Alessandro de Moura
authors.initials: Ade M
authors.lastname: Almeida
authors.affiliation: Faculdade de Medicina da Bahia, UFBA.
authors.forename: Rodrigo Morel Vieira de
authors.initials: RM
authors.lastname: Melo
authors.affiliation: Faculdade de Medicina da Bahia, UFBA.
authors.forename: Ligia Carvalho
authors.initials: LC
authors.lastname: Albuquerque
authors.affiliation: Faculdade de Medicina da Bahia, UFBA.
authors.forename: Tiana Mascarenhas
authors.initials: TM
authors.lastname: Godinho
authors.affiliation: UTI, Hospital Agenor Paiva, Salvador, BA.
authors.forename: Sydney
authors.initials: S
authors.lastname: Agareno
authors.affiliation: UTI, Hospital Salvador, Salvador, BA.
authors.forename: José Mário M
authors.initials: JM
authors.lastname: Teles
authors.affiliation: UTI Geral, Hospital Português, Salvador, BA.
authors.forename: Augusto M C
authors.initials: AM
authors.lastname: Farias
authors.affiliation: UTI Geral, Hospital Português, Salvador, BA.
authors.forename: Otavio H
authors.initials: OH
authors.lastname: Messeder