Acute and Critical Care

Original Article

Ethics
Decision-making regarding withdrawal of life-sustaining treatment and the role of intensivists in the intensive care unit: a single-center study: Seo In Lee, Kyung Sook Hong, Jin Park, Young-Joo Lee; Acute Crit Care. 2020;35(3):179-188. Published online August 10, 2020; DOI: https://doi.org/10.4266/acc.2020.00136

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Background
This study examined the experience of withholding or withdrawing life-sustaining treatment in patients hospitalized in the intensive care units (ICUs) of a tertiary care center. It also considers the role that intensivists play in the decision-making process regarding the withdrawal of life-sustaining treatment.
Methods
We retrospectively analyzed the medical records of 227 patients who decided to withhold or withdraw life-sustaining treatment while hospitalized at Ewha Womans University Medical Center Mokdong between April 9 and December 31, 2018.
Results
The 227 hospitalized patients included in the analysis withheld or withdrew from life-sustaining treatment. The department in which life-sustaining treatment was withheld or withdrawn most frequently was hemato-oncology (26.4%). Among these patients, the most common diagnosis was gastrointestinal tract cancer (29.1%). A majority of patients (64.3%) chose not to receive any life-sustaining treatment. Of the 80 patients in the ICU, intensivists participated in the decision to withhold or withdraw life-sustaining treatment in 34 cases. There were higher proportions of treatment withdrawal and ICU-to-ward transfers among the cases in whom intensivists participated in decision making compared to those cases in whom intensivists did not participate (50.0% vs. 4.3% and 52.9% vs. 19.6%, respectively).
Conclusions
Through their participation in end-of-life discussions, intensivists can help patients’ families to make decisions about withholding or withdrawing life-sustaining treatment and possibly avoiding futile treatments for these patients.

Citations

Citations to this article as recorded by

Characteristics and outcomes of patients with do-not-resuscitate and physician orders for life-sustaining treatment in a medical intensive care unit: a retrospective cohort study
Song-I Lee, Ye-Rin Ju, Da Hyun Kang, Jeong Eun Lee
BMC Palliative Care.2024;[Epub] CrossRef
Comparison of the end-of-life decisions of patients with hospital-acquired pneumonia after the enforcement of the life-sustaining treatment decision act in Korea
Ae-Rin Baek, Sang-Bum Hong, Soohyun Bae, Hye Kyeong Park, Changhwan Kim, Hyun-Kyung Lee, Woo Hyun Cho, Jin Hyoung Kim, Youjin Chang, Heung Bum Lee, Hyun-Il Gil, Beomsu Shin, Kwang Ha Yoo, Jae Young Moon, Jee Youn Oh, Kyung Hoon Min, Kyeongman Jeon, Moon S
BMC Medical Ethics.2023;[Epub] CrossRef
Dying in the ICU
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Die Anaesthesiologie.2022; 71(12): 930. CrossRef
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Acute and Critical Care.2022; 37(2): 237. CrossRef
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Journal of Palliative Medicine.2022; 25(12): 1802. CrossRef
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Yunji Lee, Minjeong Jo, Taehwa Kim, Kyoungsun Yun
BMJ Open.2021; 11(8): e049711. CrossRef

Letter to the Editor

Neurology
Posterior Reversible Encephalopathy Syndrome after Hypovolemic Shock Which Is Required Differential Diagnosis with Delirium in the Intensive Care Unit: Seo In Lee, Gyeong Seon Choi, Jin Park, Young-Joo Lee, Kyung Sook Hong; Acute Crit Care. 2018;33(4):282-285. Published online November 30, 2018; DOI: https://doi.org/10.4266/acc.2018.00262

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Citations

Citations to this article as recorded by

Posterior reversible encephalopathy syndrome in a child following hypovolemic shock: a case report
Yuvraj Adhikari, Satkirti Bista, Sammridhi Karmacharya, Binit Upadhaya Regmi, Anupama Marasini, Anisha Basukala, Shakar Bhandari, Krishna Ghimire, Ram Chandra Subedi
Annals of Medicine & Surgery.2023; 85(11): 5682. CrossRef
Clinical features and prognostic analysis of posterior reversible encephalopathy syndrome in children
Ting Deng, Xinyu Zhang, Xiaoling Peng, Hailun Peng, Ling He, Yue Hu
International Journal of Developmental Neuroscience.2022; 82(4): 349. CrossRef

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