How to discuss about do-not-resuscitate in the intensive care unit?

Teixeira, Cassiano; Cardoso, Paulo Ricardo Cerveira

doi:10.5935/0103-507x.20190051

Cited by 3 publications

(2 citation statements)

References 32 publications

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“…DNR decision may be considered in the following patients [24]: patients who may not benefit from CPR; patients for whom CPR will cause permanent impairment or loss of consciousness; patients with poor quality of life and unlikely to recover after CPR. Discussions regarding resuscitation of critically ill patients should be performed for all patients with the first 24 to 48 h after admission to the ICU [30].…”

Section: Cardiopulmonary Resuscitationmentioning

confidence: 99%

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care

et al. 2022

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Initially, palliative care in the intensive care unit (ICU) was designed to improve hospice care. Today it has emerged as a core component of ICU care. ICU palliative care should follow the ethical principles of autonomy, beneficence, nonmaleficence, justice and fidelity. To integrate primary palliative care and professional palliative care into ICU care management, there are different modes: integrative, consultative, and a combined approach. All ICU patients should receive palliative care which includes symptom management and shared decision-making. Further research is needed to explore how to provide the best palliative care for ICU patients and their families.

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Section: Cardiopulmonary Resuscitationmentioning

confidence: 99%

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care

et al. 2022

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“…In recent years, the improvement of quality of care in dealing with life-threatening conditions and the increasing attention to the impact of frailty on quality of life and mortality have prompted an ethical debate on the cruciality of patient autonomy and self-determination. The focus has progressively shifted from patient survival rate to quality of life [1]. Indeed, the implementation of resuscitation manoeuvres can certainly prevent premature death but, at the same time, may prolong agonizing conditions, cause discomfort, aggravate the emotional distress of the patients and their family, and lead to a waste of resources [2].…”

Section: Introductionmentioning

confidence: 99%

Treatment of patients with ‘do not intubate orders’

Cammarota

Simonte²,

Robertis³

2023

Current Opinion in Anaesthesiology

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Purpose of reviewDo-not-intubate (DNI) orders are more frequently encountered over time. This widespread diffusion of DNI orders make it essential to develop therapeutic strategies matching patient's and his family willingness. The present review sheds light on the therapeutic approaches employed to support respiratory function of patients with DNI orders.Recent findingsIn DNI patients, several approaches have been described to relieve dyspnoea and address acute respiratory failure (ARF). Despite its extensive use, supplemental oxygen is not so useful in assuring dyspnoea relief. Noninvasive respiratory support (NIRS) is frequently employed to treat ARF in DNI patients. Also, to enhance DNI patients comfort during NIRS, it is worthy to point out the role of analgo-sedative medications. Lastly, a particular aspect concerns the first waves of coronavirus disease 2019 pandemic, when DNI orders have been pursued on factors unrelated to patient's wishes, in the total absence of family support due to the lockdown policy. In this setting, NIRS has been extensively employed in DNI patients with a survival rate of around 20%.SummaryIn dealing with DNI patients, the individualization of treatments is of pivotal importance to respect patient's preferences and improve quality of life at the same time.

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Palliative Family Conference Reduces the Risk of Death in Intensive Care Units and Cardiopulmonary Resuscitation at End of Life

Lien

Huang

et al. 2022

Journal of Palliative Medicine

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How to discuss about do-not-resuscitate in the intensive care unit?

Cited by 3 publications

References 32 publications

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care

Palliative Care in the Intensive Care Unit: Not Just End-of-life Care

Treatment of patients with ‘do not intubate orders’

Palliative Family Conference Reduces the Risk of Death in Intensive Care Units and Cardiopulmonary Resuscitation at End of Life

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