Family discussions on life-sustaining interventions in neurocritical care

Malik Adil, D. Larriviere

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Approximately 20% of all deaths in the USA occur in the intensive care unit (ICU) and the majority of ICU deaths involves decision of de-escalation of life-sustaining interventions. Life-sustaining interventions may include intubation and mechanical ventilation, artificial nutrition and hydration, antibiotic treatment, brain surgery, or vasoactive support. Decision making about goals of care can be defined as an end-of-life communication and the decision-making process between a clinician and a patient (or a surrogate decision maker if the patient is incapable) in an institutional setting to establish a plan of care. This process includes deciding whether to use life-sustaining treatments. Therefore, family discussion is a critical element in the decision-making process throughout the patient's stay in the neurocritical care unit. A large part of care in the neurosciences intensive care unit is discussion of proportionality of care. This chapter provides a stepwise approach to hold these conferences and discusses ways to do it effectively.

Original languageEnglish (US)
Title of host publicationHandbook of Clinical Neurology
PublisherElsevier B.V.
Pages397-408
Number of pages12
DOIs
Publication statusPublished - Jan 1 2017
Externally publishedYes

Publication series

NameHandbook of Clinical Neurology
Volume140
ISSN (Print)0072-9752
ISSN (Electronic)2212-4152

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Keywords

  • decision-making
  • end-of-life
  • family discussions
  • life-sustaining interventions
  • neurocritical care unit
  • palliative care
  • withdrawal of care

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Adil, M., & Larriviere, D. (2017). Family discussions on life-sustaining interventions in neurocritical care. In Handbook of Clinical Neurology (pp. 397-408). (Handbook of Clinical Neurology; Vol. 140). Elsevier B.V.. https://doi.org/10.1016/B978-0-444-63600-3.00022-2