| Evaluating end of life practices in ten Brazilian paediatric and adult intensive care units. | |
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MedLine Citation:
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PMID: 20439333 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the modes of death and treatment offered in the last 24 h of life to patients dying in 10 Brazilian intensive care units (ICUs) over a period of 2 years. DESIGN AND SETTING: Cross-sectional, multicentre, retrospective study based on medical chart review. The medical records of all patients that died in seven paediatric and three adult ICUs belonging to university and tertiary hospitals over a period of 2 years were included. Deaths in the first 24 h of admission to the ICU and brain death were excluded. INTERVENTION: Two intensive care fellows of each ICU were trained in fulfilling a standard protocol (kappa=0.9) to record demographic data and all medical management provided in the last 48 h of life. The Student t test, Mann-Whitney U test, chi(2) test and RR were used for data comparison. MEASUREMENTS AND MAIN RESULTS: 1053 medical charts were included (59.4% adult patients). Life support limitation was more frequent in the adult group (86% vs 43.5%; p<0.001). A 'do not resuscitate' order was the most common life support limitation in both groups (75% and 66%), whereas withholding/withdrawing were more frequent in the paediatric group (33.9% vs 24.9%; p=0.02). The life support limitation was rarely reported in the medical chart in both groups (52.6% and 33.7%) with scarce family involvement in the decision making process (23.0% vs 8.7%; p<0.001). CONCLUSION: Life support limitation decision making in Brazilian ICUs is predominantly centred on the medical perspective with scarce participation of the family, and consequently several non-coherent medical interventions are observed in patients with life support limitation. |
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Authors:
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Jefferson Piva; Patr?cia Lago; Jairo Othero; Pedro Celiny Garcia; Renato Fiori; Humberto Fiori; Luiz Alexandre Borges; Fernando S Dias |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-05-03 |
Journal Detail:
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Title: Journal of medical ethics Volume: 36 ISSN: 1473-4257 ISO Abbreviation: J Med Ethics Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7513619 Medline TA: J Med Ethics Country: England |
Other Details:
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Languages: eng Pagination: 344-8 Citation Subset: E; IM |
Affiliation:
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School of Medicine, Pontif?cia Universidade Cat?lica do Rio Grande do Sul (PUCRS), Brazil. jpiva@terra.com.br |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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