Avant Leslie C, Kezar Carolyn E, Swetz Keith M
Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Palliat Med Rep. 2020 Jun 1;1(1):67-71. doi: 10.1089/pmr.2020.0002. eCollection 2020.
As options for advanced cardiopulmonary support proliferate, the use of mechanical circulatory support, such as left ventricular assist device as destination therapy (LVAD-DT), is becoming increasingly commonplace. In the current case, a patient was hospitalized for complications related to his LVAD-DT requests "full code" status, despite a clinician's warning that performing chest compressions may damage the LVAD device or vascular structures leading to poor outcome. This discussion explores the ethical and legal considerations regarding a patient request for cardiopulmonary resuscitation when limited options for survival or further treatment are available.
随着高级心肺支持的选择不断增加，机械循环支持的应用，如将左心室辅助装置作为终末期治疗（LVAD-DT），正变得越来越普遍。在当前这个病例中，一名因LVAD-DT相关并发症住院的患者要求“全力抢救”状态，尽管有临床医生警告称进行胸外按压可能会损坏LVAD装置或血管结构，从而导致不良后果。本讨论探讨了在生存或进一步治疗选择有限的情况下，患者要求进行心肺复苏时的伦理和法律考量。
