Department of Anesthesiology, Duke University School of Medicine, 2301 Erwin Road, Durham, NC 27710, USA; Department of Anesthesiology, Duke University School of Medicine, 40 Medicine Circle, Room 4317, Orange Zone, Duke Hospital South, Durham, NC 27710, USA.
Department of Anesthesiology, Duke University School of Medicine, 2301 Erwin Road, Durham, NC 27710, USA; Department of Anesthesiology, Duke University School of Medicine, 3 Genome Court, MSRB-3, 6116, Durham, NC 27710, USA.
Anesthesiol Clin. 2024 Sep;42(3):377-392. doi: 10.1016/j.anclin.2024.02.001. Epub 2024 Mar 12.
Preoperative review of existing advance directives and a discussion of patient goals should be routinely done to address any potential limitations on resuscitative therapies during perioperative care. Both surgeons and anesthesiologists should be collaboratively involved in these discussions, and all perioperative physicians should receive training in shared decision making and goals of care discussions. These discussions should center around patient preferences for limitations on life-sustaining medical therapy, which should be accurately documented and adhered to during the perioperative period. Patients should be informed that limitations of life-sustaining medical therapy may increase their risk of postoperative mortality.
在围手术期护理中，应常规进行现有预立指示的术前审查，并讨论患者的目标，以解决复苏治疗可能存在的限制。外科医生和麻醉师都应共同参与这些讨论，所有围手术期医生都应接受共同决策和护理目标讨论的培训。这些讨论应围绕患者对限制生命支持性医疗治疗的偏好展开，应在围手术期准确记录并遵守这些偏好。应告知患者，限制生命支持性医疗治疗可能会增加术后死亡风险。
