, Volume 32, Issue 10, pp 1464-1466
Date: 02 Aug 2006

Life-support limitation in the pre-hospital setting

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Consider this hypothetical scenario: A man in his late 40s is admitted to your hospital from another centre with what is thought to be an acute exacerbation of interstitial lung disease. The underlying diagnosis during a previous admission to internal medicine was uncertain but might have been adult Still's disease. Lung involvement previously was minimal. After transfer from the referring hospital, he deteriorates over a few days despite high-dose intravenous corticosteroids and is admitted to the ICU, where after some more days his oxygen requirements increase to an FiO2 of 0.9. The chest radiograph is interpreted as showing a worsening of interstitial disease. There is no other organ failure. The attending physician approaches the family with the news that “nothing further can be done.” A second ICU physician is contacted by telephone to verify the plan to withdraw life support and the man dies. At autopsy he does not have interstitial lung disease, but shows features of some diffus ...

This editorial refers to the article available at: http://dx.doi.org/10.1007/s00134-006-0292-5