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End of life management of adult patients in an Australian metropolitan intensive care unit : a retrospective observational study

Version 2 2024-06-04, 07:28
Version 1 2016-03-06, 12:31
journal contribution
posted on 2024-06-04, 07:28 authored by Melissa BloomerMelissa Bloomer, R Tiruvoipati, M Tsiripillis, JA Botha
Background Death in the intensive care unit is often predictable. End of life management is often discussed and initiated when futility of care appears evident. Respect for patients wishes, dignity in death, and family involvement in the decision-making process is optimal. This goal may often be elusive. Purpose Our purpose was to review the end of life processes and family involvement within our Unit. Methods We conducted a chart audit of all deaths in our 10 bed Unit over a 12-month period, reviewing patient demographics, diagnosis on admission, patient acuity, expectation of death and not-for-resuscitation status. Discussions with the family, treatments withheld and withdrawn and extubation practices were documented. The presence of family or next-of-kin at the time of death, the time to death after withdrawal of therapy and family concerns were recorded. Results There were 70 patients with a mean age of 69 years. Death was expected in 60 patients (86%) and not-for-resuscitation was documented in 58 cases (85%). Family discussions were held in 63 cases (90%) and treatment was withdrawn in 34 deaths (49%). After withdrawal of therapies, 31 patients (44%) died within 6 h. Ventilatory support was withdrawn in 24 cases (36%). Family members were present at the time of death in 46 cases (66%). Family concerns were documented about the end of life care in only 1 case (1.4%). Conclusion Our data suggests that death in our Unit was often predictable and that end of life management was a consultative process.

History

Journal

Australian critical care

Volume

23

Pagination

13-19

Location

Amsterdam, The Netherlands

ISSN

1036-7314

eISSN

1878-1721

Language

eng

Publication classification

C Journal article, C1.1 Refereed article in a scholarly journal

Copyright notice

2009, Australian College of Critical Care Nurses

Issue

1

Publisher

Elsevier