End-of-Life Care in the Critical Care Unit for Patients With Heart Failure

Wingate, Sue; Wiegand, Debra L.

doi:10.4037/ccn2008.28.2.84

Cited by 19 publications

(22 citation statements)

References 49 publications

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“…Accordingly, these concepts prevent medical decision. However, the communication and approach in the context of medical ethic provides all the parties to have a voice (Wingate & Wiegand, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…There may exist some ethical problems when the decision is made about the life support unit. One of these problems is that if a patient does not have legal competence, the decision of the medical team or relatives of the patient may not correspond with the patients' view about life and death (Hackett & Weisman, 1969;Wingate & Wiegand, 2008).…”

Section: Medical Ethics Principlesmentioning

confidence: 99%

“…This sort of information may be obtained from the patient or the relatives. If these probabilities are not available, medical team prognosticate about the life expectations of the patient and consider this prediction in the process of the decision (Mayer et al, 2000;Wingate & Wiegand, 2008).…”

Section: Medical Ethics Principlesmentioning

confidence: 99%

“…They are treated in the units until they are healthy enough to be treated by ordinary hospital services. These kinds of patients are treated in intensive care units and they utilize life support units if their doctor considers it necessary (D. L. Wiegand, 2006Wiegand, , 2016D. Wiegand, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Yoğun Bakim Profesyonelleri̇ni̇n Yaşamin Sonu Kararlari Hakkindaki̇ Görüşleri̇

Sevimli¹

2018

Journal of International Scientific Researches

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Development of medical technology has contributed to patients being able to lead their lives with the help of palliative care units. While the development of life-support units is welcomed, there may be existed such occasions where the usage of a life support unit questionable. Life support units give hope to the patients and their relatives in terms of expectations of life and health. However, it also leads to serious debates between health professionals and patients and their relatives. The main discussion in this unit is about the withdrawal or continuation of the life support unit. Health professionals who know the current dilemmas can play an active role in the ethical decision-making process. This study was carried out to determine the approaches of health professionals related to this topic. In this reason, questions about this work have been prepared. Prepared questionnaires about this topic were answered by the participants. The percentage of faculty members who participated in our research was 82.5% women and 17.5% men (n=85). Health care professionals expressed the intensive care unit's usefulness, they have pointed out that there were various contradictions in the patient decision-making process not only ethical but also administrational problems that life support units can cause.

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Section: Discussionmentioning

confidence: 99%

Section: Medical Ethics Principlesmentioning

confidence: 99%

Section: Medical Ethics Principlesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Yoğun Bakim Profesyonelleri̇ni̇n Yaşamin Sonu Kararlari Hakkindaki̇ Görüşleri̇

Sevimli¹

2018

Journal of International Scientific Researches

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“…Based on the current guidelines, CRT-D was indicated for patients who were on medical treatment and had moderate to severe HF, individuals with left ventricular ejection fraction of 35% or less, or patients with QRS duration of more than 120 ms. 5 In many patients with HF, the duration of QRS was less than 120 ms, 14 and thus CRT-D is not recommended; however, electrocardiographic studies indicated that 50% of these patients had dyssynchrony evidence, and therefore can benefit from CRT-D implantation. 15,16 As discussed earlier, CRT-D can improve ventricular hemodynamics and the quality of life in patients with congestive HF.…”

mentioning

confidence: 99%

Evaluation of QRS dispersion and its association withtachyarrhythmia events in patients with implantedcardiac resynchronization therapy defibrillator device

Akbarzadeh¹,

Kazemi²,

Enamzadeh³

et al. 2018

J Anal Res Clin Med

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CardiacResynchronization Therapy Defibrillator, QRS dispersionHeart failure (HF) is one of the major problems of health system in the countries. In a subgroup of these patients, cardiac resynchronization therapy defibrillator (CRT-D) improves the quality of life by enhancing the function of the left ventricle (LV) and preventing of arrhythmias. The present study intends to discuss the effect of CRT-D on the QRS dispersion, as a predisposing factor to arrhythmias. 45 patients treated with CRT-D during 2012-2015 were enrolled in this study. QRS dispersion in various V-V delays was measured and its association with the incidence of arrhythmias, at least six months after insertion, was assessed.The results showed that QRS dispersion in the intrinsic mode was significantly lower than the other modes of the CRT-D device (P < 0.001). Besides, it was revealed that mean QRS duration in the intrinsic mode had a higher association with arrhythmic events than max QRS duration. QRS dispersion after CRT-D implantation had a significant increase compared to the intrinsic mode. However, it did not correlate with the arithmetic events. Further decrease in the duration of QRS after CRT-D implantation improved arrhythmias.QRS dispersion after CRT-D implantation is not an indicative of arrhythmia risk, and a decrease in the duration of QRS had a more significant effect on the incidence of arrhythmias.

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