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为心脏病患者实施“不要复苏”医嘱的当前问题。

Current issues in implementing do-not-resuscitate orders for cardiac patients.

作者信息

Ruiz-García J, Canal-Fontcuberta I, Martínez-Sellés M

机构信息

Servicio de Cardiología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España; Facultad de Ciencias Biosanitarias, Universidad Francisco de Vitoria, Madrid, España.

Servicio de Oftalmología, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, España.

出版信息

Rev Clin Esp (Barc). 2017 May;217(4):222-228. doi: 10.1016/j.rce.2016.12.002. Epub 2017 Jan 9.

Abstract

Cardiovascular diseases are still the most common cause of death, and heart failure is the most common reason for hospitalization of patients older than 65 years. However, Cardiology attributes low importance to end-of-life care. Cardiac patients' perception of their disease's prognosis and the results of cardiopulmonary resuscitation differ greatly from reality. The "do not resuscitate" order allows patients to pre-emptively express their rejection for cardiopulmonary resuscitation, thereby avoiding its potentially negative consequences. However, these orders are still underused and misinterpreted in cardiac patients. Most of these patients usually have no opportunity to have the necessary conversations with their attending physician on their resuscitation preferences. In this review, we performed an analysis of the causes that could explain this situation.

摘要

心血管疾病仍然是最常见的死亡原因,而心力衰竭是65岁以上患者住院的最常见原因。然而,心脏病学对临终关怀的重视程度较低。心脏病患者对其疾病预后的认知以及心肺复苏的结果与现实有很大差异。“不要复苏”医嘱允许患者预先表达对心肺复苏的拒绝,从而避免其潜在的负面后果。然而,这些医嘱在心脏病患者中仍然未得到充分利用和被误解。这些患者中的大多数通常没有机会就其复苏偏好与主治医生进行必要的沟通。在本综述中,我们分析了可能解释这种情况的原因。

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