El efecto de la orden de no reanimación cardiopulmonar en el plan de atención al paciente crítico

Torre, M. Carrión; Iriarte, Emma; Monreal, María-Carmen; Coscojuela, M.A. Margall; Erro, M.C. Asiaín

doi:10.1016/s1130-2399(08)72739-1

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…Nonetheless, the proportion found in the present study was lower than in other studies and was documented later in the patient’s illness [13, 27, 37, 38]. Carrion’s [39] study found that a DNR order has an effect on the plan of care; the variations found after signing a DNR order included the withdrawal of treatments and modifications in respiratory support and the administration of vasoactive drugs and dialysis.…”

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confidence: 70%

Interventions and decision-making at the end of life: the effect of establishing the terminal illness situation

et al. 2016

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BackgroundMany ‘routine’ interventions performed in hospital rooms have repercussions for the comfort of the patient, and the decision to perform them should depend on whether the patient is identified as in a terminal phase. The aim of this study is to analyse the health interventions performed and decisions made in the last days of life in patients with advanced oncological and non-oncological illness to ascertain whether identifying the patient’s terminal illness situation has any effect on these decisions.MethodsRetrospective study of the clinical histories of deceased patients in four hospitals in Granada (Spain) in 2010. Clinical histories corresponding to the last three months of the patient’s life were reviewed.ResultsA total of 202 clinical histories were reviewed, 60 % of which were those of non-oncology patients. Opioid prescriptions (58.4 %), palliative sedation (35.1 %) and Do Not Resuscitate (DNR) orders (34.7 %) were the decisions most often reflected in the histories, and differences in these decisions were found between patients registered as terminal and those who were not registered as terminal. The most frequent interventions in the final 14 days and 48 h were parenteral hydration (96–83 %), peripheral venous catheter (90.1–82 %) and oxygen therapy (81.2–70.5 %). There were statistically significant differences between the patients who were registered as terminal and those not registered as terminal in the number of interventions applied in the final 14 days and 48 h (p = 0.01–p = 0.00) and in many of the described treatments.ConclusionThe recognition of a patient’s terminal status in the clinical history conditions the decisions that are made and is generally associated with a lower number of interventions.

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