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临终关怀及居家护理患者生命末期植入式自动心脏复律除颤器的停用

Deactivation of automatic implantable cardioverter-defibrillators in hospice and home care patients at the end of life.

作者信息

Kirk Timothy W

机构信息

Department of History and Philosphy, City University of New York-York College, 94-20 Guy R. Brewer Blvd., Jamaica, NY 11451, USA.

出版信息

Home Healthc Nurse. 2008 Jul-Aug;26(7):431-7. doi: 10.1097/01.NHH.0000326324.09466.97.

DOI:10.1097/01.NHH.0000326324.09466.97
PMID:18622221
Abstract

For patients at the end of life, active automatic implantable cardioverter-defibrillators (AICDs) may no longer achieve the treatment goals present at the time of implantation. It is possible to deactivate AICDs in patients with terminal and life-limiting diagnoses, thereby preventing the pain and distress of nontherapeutic discharge. This article presents a moral argument for the right of such patients to have their AICDs deactivated. It then explains that hospice and home care agencies have an obligation to address AICD deactivation at a policy level and offers recommendations for doing so.

摘要

对于临终患者而言，植入式心律转复除颤器（AICD）可能无法再实现植入时设定的治疗目标。对于患有终末期和危及生命疾病的患者，可以停用AICD，从而避免非治疗性电击带来的疼痛和痛苦。本文提出了一个道德论据，支持此类患者停用AICD的权利。然后解释了临终关怀机构和家庭护理机构有义务在政策层面处理AICD停用问题，并提供了相关建议。

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1
Deactivation of automatic implantable cardioverter-defibrillators in hospice and home care patients at the end of life.临终关怀及居家护理患者生命末期植入式自动心脏复律除颤器的停用
Home Healthc Nurse. 2008 Jul-Aug;26(7):431-7. doi: 10.1097/01.NHH.0000326324.09466.97.
2
Should implantable cardioverter-defibrillators and permanent pacemakers in patients with terminal illness be deactivated? Deactivating permanent pacemaker in patients with terminalillness. Patient autonomy is paramount.晚期疾病患者的植入式心脏复律除颤器和永久性起搏器是否应停用？晚期疾病患者永久性起搏器的停用。患者自主权至关重要。
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Should implantable cardioverter-defibrillators and permanent pacemakers in patients with terminal illness be deactivated? Deactivating implantable cardioverter-defibrillators and permanent pacemakers in patients with terminal illness. An ethical distinction.晚期疾病患者的植入式心脏复律除颤器和永久性起搏器是否应停用？停用晚期疾病患者的植入式心脏复律除颤器和永久性起搏器。一种伦理上的区分。
Circ Arrhythm Electrophysiol. 2009 Jun;2(3):336-9; discussion 339. doi: 10.1161/CIRCEP.108.821975.
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Deactivation of implantable cardioverter defibrillators in terminal illness and end of life care.植入式心脏复律除颤器在终末期疾病和生命终末期关怀中的停用。
Am J Cardiol. 2012 Jan 1;109(1):91-4. doi: 10.1016/j.amjcard.2011.08.011. Epub 2011 Sep 22.
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Deactivation of implanted cardioverter-defibrillators at the end of life: results of the EHRA survey.生命末期植入式心脏复律除颤器的去激活：EHRA 调查结果。
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[Deactivation of implantable defibrillators--also an ethical issue. Written routines of the process are necessary as illustrated by the described case report].[植入式除颤器的停用——也是一个伦理问题。如所描述的病例报告所示，该过程的书面流程是必要的]
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EHRA Expert Consensus Statement on the management of cardiovascular implantable electronic devices in patients nearing end of life or requesting withdrawal of therapy.EHRA 专家共识声明：心血管植入式电子设备在临近生命终末期或要求撤疗患者中的管理。
Europace. 2010 Oct;12(10):1480-9. doi: 10.1093/europace/euq275. Epub 2010 Jul 30.

引用本文的文献

1
The development of a decision aid for shared decision making in the Dutch implantable cardioverter defibrillator patient population: A novel approach to patient education.荷兰植入式心脏复律除颤器患者群体中用于共同决策的决策辅助工具的开发：一种患者教育的新方法。
Front Cardiovasc Med. 2022 Oct 13;9:946404. doi: 10.3389/fcvm.2022.946404. eCollection 2022.
2
Adverse experiences with implantable defibrillators in Oregon hospices.俄勒冈州临终关怀机构中植入式除颤器的不良事件。
Am J Hosp Palliat Care. 2011 Aug;28(5):304-9. doi: 10.1177/1049909110390505. Epub 2010 Nov 25.
3
Brief communication: Management of implantable cardioverter-defibrillators in hospice: A nationwide survey.
简讯：临终关怀中植入式心脏复律除颤器的管理：一项全国性调查。
Ann Intern Med. 2010 Mar 2;152(5):296-9. doi: 10.7326/0003-4819-152-5-201003020-00007.