[Benefits of time-limited trials in intensive-care medicine]

Abstract

A time-limited trial (TLT) is an option to deal with scarce ICU-beds. A TLT is an agreement made at an early stage of ICU-admission to initiate treatment for a certain period of time to gain a realistic understanding of the patient's chances of a meaningful recovery. If the patient improves, treatment will be continued. However, if treatment goals are not achieved, palliative care is initiated. Chang et. al. investigated the efficacy of introduction of this method. The study was conducted in 2017-2019 and consisted of the structural introduction of TLTs for ICU-patients at risk for non-beneficial ICU-treatments. The main outcome of the study is that after introduction of TLTs, the median stay at the ICU or in the hospital significantly decreased without an increase in mortality. A TLT can be of added value in Dutch ICUs, provided that the staff fully supports the method and is properly trained before implementation.