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Korean J Crit Care Med > Volume 28(3); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(3): 163-172. doi: https://doi.org/10.4266/kjccm.2013.28.3.163
중환자실 임종기 돌봄
문 재 영ㆍ신 용 섭*
충남대학교병원 호흡기내과, *충남대학교 의학전문대학원 마취통증의학교실
The End-of-Life Care in the Intensive Care Unit
Jae Young Moon, Yong Sup Shin
1Division of Pulmonary and Critical Care Medicine, Chungnam National University Hospital, Daejeon, Korea.
2Department of Anesthesiology and Pain Medicine, Chungnam National University College of Medicine, Daejeon, Korea. ysshin@cnu.ac.kr
ABSTRACT
The intensive care units (ICUs) provide the best possible medical care to help critically ill patients survive acute threats to their lives. At the same time, the ICU is also the most common place to die. Thus the ICU clinicians should be competent in all aspects for end-of-life (EOL) care. The quality of EOL care in Korean ICUs do not ensure ICU patient's autonomy and dignity at their end-of-life. For examples, several studies present that do-not-resuscitate (DNR) orders are only initiated when the patient's death in imminent. To improve understanding EOL care of terminally ill patients, we summarize 'Recommendations for EOL care in the ICU by the American College of Critical Care Medicine' and 'Consensus guidelines to withdrawing life-sustaining therapies endorsed by Korean Academy of Medical Science'. EOL care will be emerging as a comprehensive area of expertise in Korean ICUs. The ICU clinicians must strive to find the barriers for EOL care in the ICU and develop their processes to improve the care of EOL.
Key Words: autonomy; do-not-resuscitate order; end-of-life care; intensive care unit; palliative care; patient-centered care
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