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LIMITATION TRAITEMENT

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Is withdrawing treatment really more problematic than withholding treatment?

CAMERON, James ; SAVULESCU, Julian ; WILKINSON, Dominic
Journal of medical ethics, 25/05/2020, p. 1-5

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Allocating scarce resources and triaging patients during the Covid-19 pandemic

KIRKPATRICK, James N. ; HULL, Sarah C. ; FEDSON, Savitri ; MULLEN, Brendan ; GOODLIN, Sarah J.
Journal of the American College of Cardiology, 08/05/2020, p. 1-24

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Initiating end-of-life decisions with parents of infants receiving neonatal intensive care

SHAW, Chloe ; CONNABEER, Kathrina ; DREW, Paul ; GALLAGHER, Katie ; ALADANGADY, Narendra ; MARLOW, Neil
Patient education and counseling, 10/02/2020, Pagination inconnue

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Underlying goals of advance care planning (ACP) - a qualitative analysis of the literature

FLEUREN, Nienke ; DEPLA, Marja F. I. A. ; JANSSEN, Daisy J. A. ; HUISMAN, Martijn ; HERTOGH, Cees M. P. M.
BMC palliative care, 06/03/2020, vol.19, n°1, p. 1-15

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Physician Orders for Life-Sustaining Treatment and limiting overtreatment at the end of life

TRUOG, Robert D. ; FRIED, Terri R.
JAMA, 16/02/2020, p. 1-2

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Association of Physician Orders for Life-Sustaining Treatment with ICU admission among patients hospitalized near the end of life

LEE, Robert Y. ; BRUMBACK, Lyndia C. ; SATHITRATANACHEEWIN, Seelwan
JAMA, 16/02/2020, p. 1-11

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Treatment limitation and advance planning - hospital-wide audit of paediatric death

AUDIGE, Manon ; GILLAM, Lynn ; STARK, Zornitza
Journal of paediatrics and child health, 03/01/2020, Pagination inconnue

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A pilot study to evaluate compliance with guidelines for preprocedural reconsideration of code status limitations

URMAN, Richard D. ; LILLEY, Elizabeth J. ; CHANGALA, Marguerite ; LINDVALL, Charlotta ; HEPNER, David L. ; BADER, Angela M.
JOURNAL OF PALLIATIVE MEDICINE, 08/2018, vol.21, n°8, p. 1152-1156

Patients with limitation or withdrawal of life supporting care admitted in a medico-surgical intermediate care unit - prevalence, description and outcome over a six-month period

MOLMY, Perrine ; VANGRUNDERBEECK, Nicolas ; NIGEON, Olivier ; LEMYZE, Malcolm ; THEVENIN, Didier ; MALLAT, Jihad
Plos one, 2019, vol.14, n°11, p. 1-13

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Do-not-resuscitate and treatment limitation decisions - six years of experience from a Portuguese general intensive care unit

FERREIRA MONTEIRO, Nuno ; SIMOES, Isabel ; GASPAR, Isabel ; CARMO, Eduarda
Revista da associacao medica Brasileira, 2019, vol.65, n°9, p. 1168-1173

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Thème : Médecine.

FIN VIE ; EUROPE ; SOIN INTENSIF ; PRATIQUE MEDICALE ; LIMITATION TRAITEMENT

Importance: End-of-life decisions occur daily in intensive care units (ICUs) around the world, and these practices could change over time.
bjective To determine the changes in end-of-life practices in European ICUs after 16 years.
Design, Setting, and Participants: Ethicus-2 was a prospective observational study of 22 European ICUs previously included in the Ethicus-1 study (1999-2000). During a self-selected continuous 6-month period at each ICU, consecutive patients who died or had any limitation of life-sustaining therapy from September 2015 until October 2016 were included. Patients were followed up until death or until 2 months after the first treatment limitation decision.
Exposures: Comparison between the 1999-2000 cohort vs 2015-2016 cohort.
Main Outcomes and Measures: End-of-life outcomes were classified into 5 mutually exclusive categories (withholding of life-prolonging therapy, withdrawing of life-prolonging therapy, active shortening of the dying process, failed cardiopulmonary resuscitation [CPR], brain death). The primary outcome was whether patients received any treatment limitations (withholding or withdrawing of life-prolonging therapy or shortening of the dying process). Outcomes were determined by senior intensivists.
Results: Of 13 625 patients admitted to participating ICUs during the 2015-2016 study period, 1785 (13.1%) died or had limitations of life-prolonging therapies and were included in the study. Compared with the patients included in the 1999-2000 cohort (n = 2807), the patients in 2015-2016 cohort were significantly older (median age, 70 years [interquartile range {IQR}, 59-79] vs 67 years [IQR, 54-75]; P < .001) and the proportion of female patients was similar (39.6% vs 38.7%; P = .58). Significantly more treatment limitations occurred in the 2015-2016 cohort compared with the 1999-2000 cohort (1601 [89.7%] vs 1918 [68.3%]; difference, 21.4% [95% CI, 19.2% to 23.6%]; P < .001), with more withholding of life-prolonging therapy (892 [50.0%] vs 1143 [40.7%]; difference, 9.3% [95% CI, 6.4% to 12.3%]; P < .001), more withdrawing of life-prolonging therapy (692 [38.8%] vs 695 [24.8%]; difference, 14.0% [95% CI, 11.2% to 16.8%]; P < .001), less failed CPR (110 [6.2%] vs 628 [22.4%]; difference, -16.2% [95% CI, -18.1% to -14.3%]; P < .001), less brain death (74 [4.1%] vs 261 [9.3%]; difference, -5.2% [95% CI, -6.6% to -3.8%]; P < .001) and less active shortening of the dying process (17 [1.0%] vs 80 [2.9%]; difference, -1.9% [95% CI, -2.7% to -1.1%]; P < .001).
Conclusions and Relevance: Among patients who had treatment limitations or died in 22 European ICUs in 2015-2016, compared with data reported from the same ICUs in 1999-2000, limitations in life-prolonging therapies occurred significantly more frequently and death without limitations in life-prolonging therapies occurred significantly less frequently. These findings suggest a shift in end-of-life practices in European ICUs, but the study is limited in that it excluded patients who survived ICU hospitalization without treatment limitations.

Origine : PubMed

Update and recommendations in decision making referred to limitation of advanced life support treatment

ESTELLA, A. ; SARALEGUI, I. ; RUBIO SANCHIZ, O. ; HERNANDEZ-TEJEDOR, A. ; MARTIN, M. C. ; CABRE PERICAS, L. ; MASNOU BURRALLO, N. ; RECUERDA NUNEZ, M. ; MONZON, J. L. ; LOPEZ CAMPS, V.
Medicina Intensiva, 28/08/2019, Pagination inconnue

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Consentir, entre liberté et contrainte

CECCALDI, Joël
LAENNEC, 2018, vol.66, n°4, p. 34-44

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Demonstrating the impact of POLST forms on hospital care requires information not contained in state registries

TURNBULL, Alison E. ; NING, Xuejuan ; RAO, Anirudh ; TAO, Jessica J. ; NEEDHAM, Dale M.
Plos one, 2019, vol.14, n°6, 10 p.

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Withdrawing life support in pregnancy - state laws and implications for ethics

TARZIAN, Anita J.
The American journal of bioethics, 07/2017, vol.17, n°7, p. 75-76

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Racial and ethnic differences in limiting life-sustaining treatment in trauma patients

HANNA, Kamil ; PALMER, James ; CASTANON, Lourdes ; ZEESHAN, Muhammad ; HAMIDI, Mohammad ; KULVATUNYOU, Narong ; GRIES, Lynn ; JOSEPH, Bellal
The American journal of hospice and palliative care, 11/2019, vol.36, n°11, p. 974-979

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Limitation of life-sustaining care in the critically ill - a systematic review of the literature

MCPHERSON, Katie ; CARLOS, W. Graham ; EMMETT, Thomas W. ; SLAVEN, James E. ; TORKE, Alexia M.
Journal of hospital medicine, 20/02/2019, vol.14, p. E1-E8

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Retrospective review of limitations of care for inpatients at a free-standing, tertiary care children's hospital

PLYMIRE, Christopher J. ; MILLER, Elissa G. ; FRIZZOLA, Meg
Children, 10/12/2018, vol.5, n°12, p. 1-9

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Modalités de décision de limitation thérapeutique chez les traumatisés crâniens sévères - enquête auprès des neurochirurgiens en France

BOYER, F. ; AUDIBERT, G. ; BAUMANN, C. ; COLNAT-COULBOIS, S. ; PINELLI, C. ; CLAUDOT, F. ; BAUMANN, A.
Neurochirurgie, 01/12/2018, vol.64, n°6, p. 401-409

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Impact of a treatment escalation/limitation plan on non-beneficial interventions and harms in patients during their last admission before in-hospital death, using the structured judgment review method

LIGHTBODY, Calvin J. ; CAMPBELL, Jonathan N. ; HERBISON, G. Peter ; OSBORNE, Heather K. ; RADLEY, Alice ; TAYLOR, D. Robin
BMJ Open, 31/10/2018, vol.8, n°10, p. 1-7

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