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DOI: 10.4103/2229-5151.119201 Quick Response Code:
Limiting intensive care therapy in dying critically Ill patients: Experience from a tertiary care center in United Arab Emirates Ur Rahman Masood, Abuhasna Said, Chedid Faris 1, Al Mussady Mousab, Al Jundi Amer2
ABSTRACT Background: Limitations of life‑support interventions, by either withholding or withdrawing support, are integrated parts of intensive care unit (ICU) activities and are ethically acceptable. The end‑of‑life legal aspects and practices in United Arab Emirates ICUs are rarely mentioned in the medical literature. The objective of this study was to examine the current practice of limiting futile life‑sustaining therapies in our ICU, modalities for implementing of these decisions, and documentations in dying critically ill patients. Materials and Methods: This was a retrospective observational study conducted at our ICU. We studied all ICU patients who died from September 2008 to February 2009. Patients’ baseline demo‑graphics, past medical problems, diagnosis on admission to ICU, and decision to withhold, withdraw and their modalities were collected.
Departments of Critical Care Medicine and 1Neonatal Intensive Care Medicine, 2 Department of Pharmacy, Tawam Hospital, P.O. Box 15258, Al Ain, Dubai, United Arab Emirates Address for correspondence: Dr. Said Abuhasna, Department of Critical Care Medicine, Tawam Hospital, P.O. Box 15258, Al Ain, Dubai, United Arab Emirates. E‑mail: [email protected]
Results: The electronic medical records of 67 patients were reviewed. The commonest method of limiting therapy was no escalation 53.6%. Interventions were withheld in 41.5%. “Do not resuscitate” order was documented in only 16.3%. The commonest method of documenting limitation of therapy was discussion with the family and documenting the prognosis and futility of additional therapy (73.3%). Patients who died early (48 hrs) of ICU admission received terminal cardiopulmonary resuscitation more frequently (P