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End-of-life practices in traumatic brain injury patients: Report of a questionnaire from the CENTER-TBI study.
van Veen, Ernest; van der Jagt, Mathieu; Citerio, Giuseppe; Stocchetti, Nino; Epker, Jelle L; Gommers, Diederik; Burdorf, Lex; Menon, David K; Maas, Andrew I R; Lingsma, Hester F; Kompanje, Erwin J O.
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  • van Veen E; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center, Rotterdam, the Netherla
  • van der Jagt M; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: m.vanderjagt@erasmusmc.nl.
  • Citerio G; School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy; San Gerardo Hospital, ASST-Monza, Italy. Electronic address: giuseppe.citerio@unimib.it.
  • Stocchetti N; Department of Physiopathology and Transplantation, Milan University, Milan, Italy; Neuro ICU Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milan, Italy. Electronic address: nino.stocchetti@policlinico.mi.it.
  • Epker JL; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: j.epker@erasmusmc.nl.
  • Gommers D; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: d.gommers@erasmusmc.nl.
  • Burdorf L; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: a.burdurf@erasmusmc.nl.
  • Menon DK; Department of Anaesthesia, University of Cambridge, Cambridge, United Kingdom. Electronic address: dkm13@cam.ac.uk.
  • Maas AIR; Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium. Electronic address: andrew.Maas@uza.be.
  • Lingsma HF; Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: h.lingsma@erasmusmc.nl.
  • Kompanje EJO; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Medical Ethics and Philosophy of Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: e.j.o.kompanje@erasmusmc.nl.
J Crit Care ; 58: 78-88, 2020 08.
Article en En | MEDLINE | ID: mdl-32387842
PURPOSE: We aimed to study variation regarding specific end-of-life (EoL) practices in the intensive care unit (ICU) in traumatic brain injury (TBI) patients. MATERIALS AND METHODS: Respondents from 67 hospitals participating in The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study completed several questionnaires on management of TBI patients. RESULTS: In 60% of the centers, ≤50% of all patients with severe neurological damage dying in the ICU, die after withdrawal of life-sustaining measures (LSM). The decision to withhold/withdraw LSM was made following multidisciplinary consensus in every center. Legal representatives/relatives played a role in the decision-making process in 81% of the centers. In 82% of the centers, age played a role in the decision to withhold/withdraw LSM. Furthermore, palliative therapy was initiated in 79% of the centers after the decision to withdraw LSM was made. Last, withholding/withdrawing LSM was, generally, more often considered after more time had passed, in a patient with TBI, who remained in a very poor prognostic condition. CONCLUSION: We found variation regarding EoL practices in TBI patients. These results provide insight into variability regarding important issues pertaining to EoL practices in TBI, which can be useful to stimulate discussions on EoL practices, comparative effectiveness research, and, ultimately, development of recommendations.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Muerte / Lesiones Traumáticas del Encéfalo / Unidades de Cuidados Intensivos Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies Límite: Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pautas de la Práctica en Medicina / Muerte / Lesiones Traumáticas del Encéfalo / Unidades de Cuidados Intensivos Tipo de estudio: Clinical_trials / Guideline / Prognostic_studies Límite: Humans / Middle aged País/Región como asunto: Europa Idioma: En Revista: J Crit Care Asunto de la revista: TERAPIA INTENSIVA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos