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Recomendaciones de tratamiento al final de la vida del paciente crítico

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TLDR
In this article, the SEMICYUC Working Group of Bioethics elaborates these Recommendations of treatment at the end of the life of the critical patient in order to contribute to the improvement of our daily practice in such a difficult field.
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This article is published in Medicina Intensiva.The article was published on 2008-03-01 and is currently open access. It has received 134 citations till now. The article focuses on the topics: Palliative care & Advance care planning.

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How Spain Reached 40 Deceased Organ Donors per Million Population.

TL;DR: The Spanish results are to be highlighted in the context of the dramatic decline in the incidence of brain death and the changes in end‐of‐life care practices in the country since the beginning of the century.
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Donation after circulatory death and its expansion in Spain.

TL;DR: D has been successfully developed in Spain following a streamlined process and nRP may become a standard in DCD, although further evidence on the benefits of this technology is eagerly awaited.
References
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A controlled trial to improve care for seriously ill hospitalized patients: The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT)

TL;DR: A 2-year prospective observational study (phase I) with 4301 patients followed by a two-year controlled clinical trial (phase II) with 4804 patients and their physicians randomized by specialty group to the intervention group or control group (n=2652).
Journal ArticleDOI

Patterns of functional decline at the end of life.

TL;DR: To determine if functional decline differs among 4 types of illness trajectories: sudden death, cancer death, death from organ failure, and frailty, Cohort analysis of data from 4 US regions in theEPESE study found Trajectories of functional decline at the end of life are quite variable.
Journal ArticleDOI

Use of intensive care at the end of life in the United States: an epidemiologic study.

TL;DR: One in five Americans die using ICU services and the doubling of persons over the age of 65 yrs by 2030 will require a system-wide expansion in ICU care for dying patients unless the healthcare system pursues rationing, more effective advanced care planning, and augmented capacity to care for Dying patients in other settings.
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End-of-life practices in European intensive care units: the Ethicus Study.

TL;DR: The limiting of life-sustaining treatment in European ICUs is common and variable and clarity between withdrawing therapies and shortening of the Dying process and between therapies intended to relieve pain and suffering and those intended to shorten the dying process may be lacking.
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Frequently Asked Questions (3)
Q1. What have the authors contributed in "(121-133) recomendaciones de tratamiento.....qxp" ?

In this paper, el Grupo de trabajo de Bioethica de la SEMICYUC elabora estas recomendaciones de tratamiento al final de la vida del paciente crítico con el propósito de contribuir a la mejora de nuestra práctica diaria in tan difícil campo. 

Este estudio de dos fases, con casi 10.000 pacientes en 5 grandes hospitales estadounidenses, reveló serias limitaciones en el tratamiento de los pacientes con enfermedades graves. 

End-of-life treatment of critical patients and attention to the needs of their relatives is far from being adequate for several reasons: society denies or hides the death, it is very difficult to predict it accurately, treatment is frequently fragmented between different specialists and there is insufficient palliative medicine training, including communication skills.