The Impact of Signing Do-Not-Resuscitate Orders on the Use of Non-Beneficial Life-Sustaining Treatments for Intensive Care Unit Patients: A Retrospective Study

Background: Intensive care medical technology increases the survival rate of critically ill patients. However, life-sustaining treatments also increase the probability of non-beneficial medical treatments given to patients at the end of life. Objective: This study aimed to analyse whether patients w...

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Published in:International journal of environmental research and public health 2022-08, Vol.19 (15), p.9521
Main Authors: Shiu, Shang-Sin, Lee, Ting-Ting, Yeh, Ming-Chen, Chen, Yu-Chi, Huang, Shu-He
Format: Article
Language:English
Subjects:
Cardiopulmonary resuscitation
Clinical trials
CPR
Critical Care
Critical Illness
Data collection
End of life
First aid
Heart
Hospitals
Humans
Hypotheses
Intensive care
Intensive Care Units
Intubation
Medical records
Medical technology
Medical treatment
Palliative care
Patients
Physiology
Professional ethics
Resuscitation
Resuscitation Orders
Retrospective Studies
Survival
Ventilators
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Summary:Background: Intensive care medical technology increases the survival rate of critically ill patients. However, life-sustaining treatments also increase the probability of non-beneficial medical treatments given to patients at the end of life. Objective: This study aimed to analyse whether patients with a do-not-resuscitate (DNR) order were more likely to be subject to the withholding of cardiac resuscitation and withdrawal of life-sustaining treatment in the ICU. Methods: This retrospective study collected data regarding the demographics, illness conditions, and life-sustaining treatments of ICU patients who were last admitted to the ICU between 1 January 2016 and 31 December 2017, as determined by the hospital’s electronic medical dataset. Results: We identified and collected data on 386 patients over the two years; 319 (82.6%) signed a DNR before the end. The study found that DNR patients were less likely to receive cardiac resuscitation before death than non-DNR patients. The cardiac resuscitation treatments included chest compressions, electric shock, and cardiotonic drug injections (p < 0.001). However, the life-sustaining treatments were withdrawn for only a few patients before death. The study highlights that an early-documented DNR order is essential. However, it needs to be considered that promoting discussions of time-limited trials might be the solution to helping ICU terminal patients withdraw from non-beneficial life-sustaining treatments.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph19159521