Care at the End of Life for Patients with Respiratory Failure

2010 ◽  
pp. 2160-2179 ◽  
Author(s):  
John M. Luce ◽  
Douglas B. White
Keyword(s):  
Respiratory Failure ◽  
End Of Life

scholarly journals End-of-life decision making in respiratory failure. The therapeutic choices in chronic respiratory failure in a 7-item questionnaire

2012 ◽  
Vol 48 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Dagmar Elfriede Rinnenburger ◽  
Mario Giuseppe Alma ◽  
Domenico Bigioni ◽  
Giuseppe Brunetti ◽  
Carlo Liberati ◽  
...  
Keyword(s):  
Decision Making ◽  
Respiratory Failure ◽  
End Of Life ◽  
Chronic Respiratory Failure ◽  
Item Questionnaire ◽  
End Of Life Decision ◽  
Life Decision

scholarly journals ECCO2R as a bridge to a decision in type II respiratory failure

2019 ◽  
Vol 26 (1) ◽  
pp. 101-106
Author(s):  
Lina Grauslytė ◽  
Gonzalo De La Cerda ◽  
Tomas Jovaiša
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Respiratory Failure ◽  
End Of Life ◽  
Lung Transplant ◽  
Life Support ◽  
Support Systems ◽  
Extracorporeal Life Support ◽  
Life Support Systems ◽  
End Of Life Decisions

Introduction. End-of-life decisions are often time consuming and difficult for everyone involved. In some of these cases extracorporeal life support systems could potentially be used not only as a bridge to treatment but as a tool to buy time to allow patient’s participation in decision making and to avoid further futile invasive procedures. Case report. A previously healthy 53-year-old female patient presented with respiratory failure of unknown cause. In the course of treatment her condition was deemed irreversible and the only option for any chance of long-term survival was a lung transplant. During this whole time the patient’s condition was managed with extracorporeal carbon dioxide removal system (ECCO2R). She remained compos mentis and expressed the wish to stop all the treatment as the option of lung transplant was not acceptable to her. Treatment was withdrawn and she passed away. Discussion. In cases of end-of-life decisions, time can play an essential role. Even though extracorporeal life support systems have been conceptualised to be a bridge to treatment, they could be beneficial in a situation when time is needed to make a decision. ECCO2R has been used as a treatment method in different settings, however, in this case it served as a tool to maintain the patient alive and conscious for a sufficient time for her to participate in decision making. Conclusions. Our case report demonstrated that ECCO2R could serve as a bridge to decision in situations when time is limited and the decisions that need to be made are difficult.

Noninvasive ventilation for acute respiratory failure near the end of life*

2008 ◽  
Vol 36 (3) ◽  
pp. 789-794 ◽  
Author(s):  
Tasnim Sinuff ◽  
Deborah J. Cook ◽  
Sean P. Keenan ◽  
Karen E. A. Burns ◽  
Neill K. J. Adhikari ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
End Of Life ◽  
Noninvasive Ventilation

scholarly journals The opinion of French pulmonologists and palliative care physicians on non-invasive ventilation during palliative sedation at end of life: a nationwide survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
V. Guastella ◽  
G. Piwko ◽  
A. Greil ◽  
C. Lambert ◽  
A. Lautrette
Keyword(s):  
Palliative Care ◽  
Respiratory Failure ◽  
End Of Life ◽  
Palliative Sedation ◽  
Invasive Ventilation ◽  
Factors Associated ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Care Training ◽  
Personal Ethics

Abstract Background Deciding to withdraw non-invasive ventilation (NIV) at end-of-life (EOL) in patients with chronic respiratory failure is a challenge. The European Association for Palliative Care recommends not maintaining artificial therapies that could prolong life during palliative sedation (PS) at EOL. The aim of this survey was to assess palliative care physicians’ and pulmonologists’ opinion on withdrawing or maintaining NIV in patients with chronic respiratory failure during PS at EOL. Methods From April to May 2019, we performed a prospective survey among pulmonologists (n = 1545) and palliative care physicians (n = 631) in France to determine the prevalence of opinion in favour of maintaining NIV and identify the factors associated with opinion in favour of withdrawing or maintaining NIV with multiple logistic regression. Results A total of 457 participants were enrolled comprising 202 pulmonologists and 255 palliative care physicians. An opinion in favour of maintaining NIV was found in 88 (19.3 95%CI [15.7; 23.2]) physicians comprising 57 (28.2%) pulmonologists and 31 (12.2%) palliative care physicians (p < 0.001). The factors associated with an opinion in favour of maintaining NIV were spending time looking for advanced directives (AD) in the patient’s file (odds ratio (OR): 6.54, 95%CI [2.00; 21.32], p = 0.002) and personal ethics of physicians (OR: 17.97, 95%CI [9.52; 33.89], p < 0.001). The factor associated with an opinion in favour of withdrawing NIV was palliative care training (OR: 0.31, 95%CI [0.16; 0.60], p < 0.001). The three main reasons in favour of maintaining NIV among the nine identified were emotional comfort for close relatives, reducing discomfort of dyspneoa and anticipation of suffocation. Conclusion In France, around 20% of pulmonologists and palliative care physicians declared an opinion in favour of maintaining NIV during PS at EOL because of their personal ethics and spending time looking for AD, if any, in the patient’s file. Palliative care training can stimulate reflection help foster a change of opinion about practices, especially in the case of patients with NIV during PS at EOL.

Telemedicine to support end of life in severe chronic respiratory failure patients at home

2009 ◽  
Vol 7 (2) ◽  
pp. 85-90 ◽  
Author(s):  
M. Vitacca ◽  
G. Assoni ◽  
S. Gilè ◽  
D. Fiorenza ◽  
L. Bianchi ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
End Of Life ◽  
Chronic Respiratory Failure ◽  
At Home

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

Sign in / Sign up

Export Citation Format

Share Document