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Ethics consultations in the intensive care unit (ICU) reduced duration of ICU stay and time on aggressive, life sustaining treatments with no change in overall mortality

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QUESTION: Do ethics consultations in the intensive care unit (ICU) reduce length of ICU stay and aggressive, life sustaining treatments in patients who ultimately die before discharge?

Design

Randomised {allocation concealed}*, unblinded, controlled trial with follow up to hospital discharge.

Setting

Medical and paediatric ICUs in a university medical centre in San Diego, California, USA.

Patients

74 patients identified by nurses when value based treatment conflicts arose during the course of treatment. Types of conflict included disputes with family members or among the healthcare team about changes to patient resuscitation status, intubation or extubation, or the use of aggressive life saving measures. 70 patients (95%) were included in the intention to treat analysis (mean age 49 y, 61% men).

Intervention

37 patients were allocated to the intervention, in …

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Footnotes

  • * Information provided by author.

  • Source of funding: in part, US Agency for Health Care Policy and Research.

  • For correspondence: Dr L J Schneiderman, University of California, San Diego, School of Medicine, 9500 Gilman Drive, M/C 0622, La Jolla, CA 92093-0622, USA. Fax +1 858 534 7053.