Suivi des limitations thérapeutiques après mise en place d'une procédure d'aide en réanimation

To achieve improved quality of care for the end-of-life patients, a procedure for withholding and withdrawing life-sustaining treatment has been introduced in our intensive care unit. The study's main objective is to observe the impact of this procedure for withholding and withdrawing life-sustaining treatment two years after. Two hundred and ninety-five deceased patients have been included in this retrospective single centre study. Data collection from 2010 and 2012 about the patients and the withholding and withdrawing of life-sustaining treatment were compared. Death rate during the inclusion period was of 20%. Seventy percent of the deaths were preceded by a withholding and withdrawing life-sustaining treatment. Secondary benefits of this procedure for withholding and withdrawing of life-sustaining treatment was ongoing in 2012, such as the traceability of the withholding and withdrawing of life-sustaining treatment, the information of the family and the nurse' satisfaction. Significantly fewer withholding and withdrawing of life-sustaining treatment were decided during the first week of hospitalization in 2012 than in 2010 (respectively 45 [47%] versus 69 [62%]; P = 0.027). The conditions and modalities for the withholding and withdrawing of life-sustaining treatment were similar in 2010 and 2012. Comfort cares were performed similarly between 2010 and 2012. A procedure for withholding and withdrawing life-sustaining treatment results in numerous secondary benefits. These benefits persist over time even if reminders are needed.