eISSN: 2081-2833
ISSN: 2081-0016
Medycyna Paliatywna/Palliative Medicine
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors Publication charge Ethical standards and procedures
Editorial System
Submit your Manuscript
4/2023
vol. 15
 
Share:
Share:
abstract:
Original paper

Time-limited trial – searching for rational solutions in the functioning of intensive care units

Maria Damps
1
,
Ewa Kucewicz-Czech
2

  1. Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
  2. Department of Cardiac Anaesthesia and Intensive Therapy, Medical University of Silesia, Silesian Centre for Heart Diseases, Zabrze, Poland
Medycyna Paliatywna 2023; 15(4): 188–192
Online publish date: 2023/12/29
View full text Get citation
 
PlumX metrics:
Introduction
Evaluating futility carries the burden of subjectivity; we do not have scales that verify the impartiality of decisions. It is very difficult to decide on the fate of a patient who shows up intubated at the Intensive Care Unit (ICU). The uncertainty of the prognosis at the beginning of a critical illness does not allow the doctor to predict the effect of therapy in terms of survival, regaining the previous quality of life, and independent functioning.

Material and methods
There are 3 options to choose from: ICU admission and all invasive procedures; refusal of ICU admission, with a sense of making decisions based on incomplete information; and a time-limited trial, which allows testing invasive procedures aimed at the potential improvement of the patient’s health and the reassessment of gains and losses after a specific, defined period. It seems that the last solution is fair and acceptable to the patient/family and medics.

Results
A time-limited trial is part of the concept of personalized medicine, which puts the patient at the centre of our actions. A time-limited trial is a practical proposition for patients with a doubtful prognosis and uncertainty concerning the effects of invasive and aggressive therapies.

Conclusions
Patients with a limited life expectancy and exhausted physiological reserves are ideal candidates for the implementation of the described method.

keywords:

intensive care, futility therapy, time-limited trial

FEATURED PRODUCTS
BOOKS
Medycyna Paliatywna
Quick links
© 2024 Termedia Sp. z o.o.
Developed by Bentus.