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Nondialytic Therapy for Elderly Patients in a Critical Care Setting
It is frequently necessary to admit critically ill elderly patients to intensive care units (ICUs) due to their physiological impairments and co-morbidities. Several life-sustaining therapies such as mechanical ventilation are performed as necessary treatment in these ICUs. Sometimes renal replaceme...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107387/ https://www.ncbi.nlm.nih.gov/pubmed/25076960 http://dx.doi.org/10.1159/000363733 |
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author | Ishikawa, Hideaki Sakamoto, Junichi |
author_facet | Ishikawa, Hideaki Sakamoto, Junichi |
author_sort | Ishikawa, Hideaki |
collection | PubMed |
description | It is frequently necessary to admit critically ill elderly patients to intensive care units (ICUs) due to their physiological impairments and co-morbidities. Several life-sustaining therapies such as mechanical ventilation are performed as necessary treatment in these ICUs. Sometimes renal replacement therapy (i.e. dialysis) is considered for elderly patients with complicating serious renal insufficiency. However, although the necessity for dialysis is recognized, some elderly patients may not benefit from this care because of their limited life expectancy. Until recently, life-sustaining support for critically ill elderly patients in Japan has been used routinely, regardless of the medical futility. The issue of providing better end-of-life care for elderly patients even in the ICU is now being raised frequently. We therefore wish to highlight the issue of end-of-life care and decision-making in the ICU, focusing on nondialytic therapy (NDT). The aim of this article was to assess whether NDT is an acceptable optional care for critically ill elderly patients with serious kidney diseases, even in the ICU. We hope our experiences may be helpful to physicians with an interest in decision-making and end-of-life care. |
format | Online Article Text |
id | pubmed-4107387 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-41073872014-07-30 Nondialytic Therapy for Elderly Patients in a Critical Care Setting Ishikawa, Hideaki Sakamoto, Junichi Case Rep Nephrol Urol Published online: June, 2014 It is frequently necessary to admit critically ill elderly patients to intensive care units (ICUs) due to their physiological impairments and co-morbidities. Several life-sustaining therapies such as mechanical ventilation are performed as necessary treatment in these ICUs. Sometimes renal replacement therapy (i.e. dialysis) is considered for elderly patients with complicating serious renal insufficiency. However, although the necessity for dialysis is recognized, some elderly patients may not benefit from this care because of their limited life expectancy. Until recently, life-sustaining support for critically ill elderly patients in Japan has been used routinely, regardless of the medical futility. The issue of providing better end-of-life care for elderly patients even in the ICU is now being raised frequently. We therefore wish to highlight the issue of end-of-life care and decision-making in the ICU, focusing on nondialytic therapy (NDT). The aim of this article was to assess whether NDT is an acceptable optional care for critically ill elderly patients with serious kidney diseases, even in the ICU. We hope our experiences may be helpful to physicians with an interest in decision-making and end-of-life care. S. Karger AG 2014-06-14 /pmc/articles/PMC4107387/ /pubmed/25076960 http://dx.doi.org/10.1159/000363733 Text en Copyright © 2014 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions. |
spellingShingle | Published online: June, 2014 Ishikawa, Hideaki Sakamoto, Junichi Nondialytic Therapy for Elderly Patients in a Critical Care Setting |
title | Nondialytic Therapy for Elderly Patients in a Critical Care Setting |
title_full | Nondialytic Therapy for Elderly Patients in a Critical Care Setting |
title_fullStr | Nondialytic Therapy for Elderly Patients in a Critical Care Setting |
title_full_unstemmed | Nondialytic Therapy for Elderly Patients in a Critical Care Setting |
title_short | Nondialytic Therapy for Elderly Patients in a Critical Care Setting |
title_sort | nondialytic therapy for elderly patients in a critical care setting |
topic | Published online: June, 2014 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107387/ https://www.ncbi.nlm.nih.gov/pubmed/25076960 http://dx.doi.org/10.1159/000363733 |
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