DANIEL NEVES FORTE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
LIM/51 - Laboratório de Emergências Clínicas, Hospital das Clínicas, Faculdade de Medicina
2 resultados
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Agora exibindo 1 - 2 de 2
- Editorial: Advance Care Planning as Key to Person Centered Care: Evidence and Experiences, Programmes and Perspectives(2023) KRONES, Tanja; ANDERSON, Stephanie; BORENKO, Cari; FROMME, Erik; GOETZE, Kornelia; LASMARIAS, Cristina; LIN, Cheng-Pei; FORTE, Daniel Neves; NG, Raymond; SIMON, Jessica; SINCLAIR, Craig
- Limiting life-sustaining treatment for very old ICU patients: cultural challenges and diverse practices(2023) BEIL, Michael; HEERDEN, Peter Vernon van; JOYNT, Gavin M.; LAPINSKY, Stephen; FLAATTEN, Hans; GUIDET, Bertrand; LANGE, Dylan de; LEAVER, Susannah; JUNG, Christian; FORTE, Daniel Neves; BIN, Du; ELHADI, Muhammed; SZCZEKLIK, Wojciech; SVIRI, SigalBackgroundDecisions about life-sustaining therapy (LST) in the intensive care unit (ICU) depend on predictions of survival as well as the expected functional capacity and self-perceived quality of life after discharge, especially in very old patients. However, prognostication for individual patients in this cohort is hampered by substantial uncertainty which can lead to a large variability of opinions and, eventually, decisions about LST. Moreover, decision-making processes are often embedded in a framework of ethical and legal recommendations which may vary between countries resulting in divergent management strategies.MethodsBased on a vignette scenario of a multi-morbid 87-year-old patient, this article illustrates the spectrum of opinions about LST among intensivsts with a special interest in very old patients, from ten countries/regions, representing diverse cultures and healthcare systems.ResultsThis survey of expert opinions and national recommendations demonstrates shared principles in the management of very old ICU patients. Some guidelines also acknowledge cultural differences between population groups. Although consensus with families should be sought, shared decision-making is not formally required or practised in all countries.ConclusionsThis article shows similarities and differences in the decision-making for LST in very old ICU patients and recommends strategies to deal with prognostic uncertainty. Conflicts should be anticipated in situations where stakeholders have different cultural beliefs. There is a need for more collaborative research and training in this field.