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Volume 3 Supplement 1

ESICM LIVES 2015

Evaluation of severity in critically ill patients (cips) with limitation of life-sustaining therapy (LLST)

Introduction

It is considered that the severity of CIPs with LLSt is higher than the overall CIPs requiring ICU admission. The identification of specific clinical variables which determine the severity of the CIPs with LLST perhaps has not been researched enough.

Objectives

  • To asses the severity of the CIPs with LLST in comparison to CIPs with LLS.

  • To evaluate and compare the mortality between two populations.

Methods

  • Type of study: prospective, analytical, longitudinal, and observational

  • Period: January 1-2011 / June 30-2014 (42 months)

  • Setting : Medical / Surgical ICU

  • Population: 2559 CIPs admitted consecutively to the ICU; sample: 220 CIPs with LLST.

  • Exclusión criteria: CIPs < 16 y., major burn CIPs, incomplete clinical documentation, and voluntary discharge.

  • Variables analyzed:

  1. a)

    Age

  2. b)

    Hospital mortality

  3. c)

    Case - mix: severe sepsis, metabolic acidosis, total parenteral nutrition (TPN), oncological pathology, intra-abdominal pressure (IAP), blood products, cultures, cardiac continous output (CCO), advanced life support (ALS) before LLTS applied, FGC, FBC.

  • Statistical analysis: Ji squared and contrast of means (Student's t)

Results

See tables 1 and 2.

Table 1 Results 1.
Table 2 Results II.

Conclusions

  • More than 50 % of CIPs with LLST die.

  • According to all clinical variables, SS, metabolic acidosis, TPN, IAP, blood products, cultures, ALS, FGC, FBC, and cardiac output are much higher in CIPs with LLST.

References

  1. 1.

    Wiegand DL, Grant MS: Bioethical Issues Related to Limiting Life-sustaining Therapies in the Intensive Care Unit Disclosures. J Hospice Palliative Nursing. 2014, 16 (2): 60-64. 10.1097/NJH.0000000000000049.

  2. 2.

    Wunsch H, Harrison DA, Harvey S, Rowan K: End of life decisions: a cohort study of the withdrawl of all active treatment in intensive care units in the United Kingdom. Intensive Care Med. 2005, 31: 823-31. 10.1007/s00134-005-2644-y.

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Author information

Correspondence to J Ruiz Moreno.

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Keywords

  • Public Health
  • Cardiac Output
  • Severe Sepsis
  • Clinical Variable
  • Parenteral Nutrition