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Addressing Inadequate Documentation of Unilateral Do-Not-Resuscitate Orders.
JAMA
January 2025
Department of Pulmonary and Critical Care, University of Chicago, Chicago, Illinois.
Peak serum lactate as a robust predictor of imminent death in life-sustaining treatment decisions: A study of 73,927 patients.
Sci Prog
January 2025
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Objective: The physician order for life-sustaining treatment has been implemented in clinical practice for several years. However, the determination that a patient is in the terminal phase of life, a prerequisite for the withdrawal of life-sustaining treatment, lacks objective criteria. This study aimed to evaluate whether hyperlactatemia could serve as a reliable objective indicator for determining the terminal phase.
View Article and Find Full Text PDFThe Patient Perspective on Discussion of Perioperative Code Status: A Blind Spot in Efforts to Promote Goal-Concordant Surgical Care.
J Palliat Med
January 2025
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Despite long-standing recognition that providers should discuss DNR (do-not-resuscitate) orders prior to surgery, there is evidence that perioperative code status discussions are frequently of limited quality. Limited attention has been paid to patient perspectives. Determine the scope of literature on management of perioperative DNR orders from the patient perspective.
View Article and Find Full Text PDFUntil the beginning of the century, bleeding management was similar in elective surgeries or exsanguination scenarios: clotting tests were used to guide blood product orders and, while awaiting these results, an aggressive resuscitation with crystalloids was recommended. The high mortality rate in severe hemorrhages managed with this strategy endorsed the need for a special resuscitation plan. As a result, modifications were recommended to develop a new clinical approach to these patients, called "Damage Control Resuscitation".
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