Translation of patients' advance directives in intensive care units: are we there yet?

Article Critical Care Medicine

Global Comparison of Communication of End-of-Life Decisions in the ICU

Charles Feldman et al.

Summary: The possibility of prolonging life in the ICU is increasing, resulting in decisions to limit life-sustaining therapies. This study examined communication practices at the end of life in ICUs worldwide and found significant regional differences. The study also suggested that ethical practice and the presence of an advance directive may increase the likelihood of communication. Efforts are needed to align treatment with patients' wishes.

CHEST (2022)

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Article Public, Environmental & Occupational Health

Emergency Department and Intensive Care Unit Overcrowding and Ventilator Shortages in US Hospitals During the COVID-19 Pandemic, 2020-2021

Paramjit Sandhu et al.

Summary: This study investigated the levels of emergency department (ED) and intensive care unit (ICU) overcrowding, as well as ventilator shortages, in several US hospitals during the COVID-19 pandemic. The results showed that among the participating hospitals, approximately 63% reported overcrowding, with 63% reporting ED overcrowding, 61% reporting ICU overcrowding, and 12% reporting ventilator shortages. The number of overcrowding alerts in EDs and ICUs increased as the number of COVID-19 cases surged.

PUBLIC HEALTH REPORTS (2022)

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Article Critical Care Medicine

Dying in the Neurointensive Care Unit After Withdrawal of Life-Sustaining Therapy: Associations of Advance Directives and Health-Care Proxies With Timing and Treatment Intensity

Frank Stachulski et al.

Summary: In a German neurointensive care unit, the presence of advance directives or health-care proxies was not associated with earlier withdrawal or withholding of life-sustaining therapy, nor with differences in treatment intensity before such action. Future studies should further explore the concept of advance care planning in neurocritical care.

JOURNAL OF INTENSIVE CARE MEDICINE (2021)

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Article Medicine, General & Internal

End-of-Life Decision-Making in Intensive Care Ten Years after a Law on Advance Directives in Germany

Jan A. Graw et al.

Summary: Following the implementation of a law on advance directives in Germany, the frequency of end-of-life decisions (EOLDs) and completion rate of advance directives among ICU patients have significantly increased over a ten-year period. Additionally, the involvement of patient families in EOLD processes and the documentation of relevant information have improved.

MEDICINA-LITHUANIA (2021)

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Article Medicine, General & Internal