Abstract
Objective: The purpose of the study was to obtain information about patients experiencing any form of limi-tation of therapy (withdrawal -WD, or withholding -WH of therapy) and the way it is performed on the ICU. Design: Prospective, multi-centre, one-day prevalence study.
Setting: Intensive Care units. Materials and Methods: An analysis of the posted questionnaires regarding ICU patients with limitations of therapy on the day of the study (16/3/2005) was performed.
Information about the type of ICU, the patients with limitation of therapy and its form was obtained. Attention was paid to the documentation of EOLD in patient charts, informing the family and the maintained therapy.
Results: 78 ICUs in the Czech Republic took part in the survey. 32 (41%) of them were university-based, 39 (44%) were based in regional hospitals. 56 of the ICUs were run by anaesthesiologists and 22 by other spe-cialties. On the day of the study there were 574 patients hospitalized on ICUs.
In 48 (8.36%) of them withholding or withdrawal of therapy had been initiated. Limitation of therapy was documented in the patient charts in 79% of the cases, the family was informed in 64%.
WH was employed in 31 (64.6%) patients, WD in 15 (31.2%) and terminál weaning in 1 patient (2%). WD was more frequent in university-based ICUs, WH in regional hospitals.
The most commonly maintained supportive measures during EOLD included parenteral infusions, nutrition, analgesia with sedation and ventilátory support. Conclusion: The study documented the current techniques ušed in EOLD on ICUs in the Czech Republic.
Withholding of therapy is generally preferred to withdrawal. The most frequently withdrawn therapeutic measures are haemodialysis and administration of catecholamines.
Analgesia and sedation, nutrition, antibiotics and ventilátory support are usually maintained. Termination of ventilátory support is rarely ušed.