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. 2022 Aug 3;19(15):9521.
doi: 10.3390/ijerph19159521.

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

Shang-Sin Shiu  1 , Ting-Ting Lee  2 , Ming-Chen Yeh  3 , Yu-Chi Chen  4 , Shu-He Huang  2
Affiliations

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

Shang-Sin Shiu et al. Int J Environ Res Public Health. .

Abstract

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 However, the life-sustaining treatments were withdrawn for only a few patients before death.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.

Keywords: DNR; life-sustaining treatments; non-beneficial; resuscitation; withdrawal.

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Conflict of interest statement

The authors have no financial or other conflict of interest to declare.

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