Morrison Laura J, Calvin Amy O, Nora Hope, Porter Storey C
Department of Medicine, Section of Geriatrics, Baylor College of Medicine, Houston, TX, USA.
Am J Hosp Palliat Care. 2010 Dec;27(8):545-51. doi: 10.1177/1049909110373363. Epub 2010 Aug 16.
Implantable cardioverter defibrillators (ICDs) and pacemakers may change the character of an individual's eventual death. The objective of this study was to explore hospice and palliative care provider attitudes and experience in managing ICDs and pacemakers for patients near the end of life. A voluntary survey was distributed to session attendees at a national conference. Doctors and nurses surveyed overwhelmingly agreed it is appropriate to disable these devices in a terminally ill patient who does not wish to be resuscitated or prolong life. However, respondents emphasized a less defined burden for pacemakers. Respondents also reported limited involvement in such cases and few institutional protocols. As more terminal patients have these devices, research and education on device management protocols/guidelines and on provider communication skills are critical.
植入式心脏复律除颤器（ICD）和起搏器可能会改变个体最终死亡的特征。本研究的目的是探讨临终关怀和姑息治疗提供者在管理临终患者的ICD和起搏器方面的态度和经验。一项自愿调查被分发给了一次全国会议的参会者。接受调查的医生和护士绝大多数都认为，在不希望被复苏或延长生命的绝症患者中禁用这些设备是合适的。然而，受访者强调起搏器的负担不太明确。受访者还报告称在这类病例中的参与有限，且机构协议很少。随着越来越多的晚期患者使用这些设备，对设备管理协议/指南以及提供者沟通技巧的研究和教育至关重要。
