Narcotic and benzodiazepine use after withdrawal of life support: association with time to death?

Chest
Jeannie D ChanJ Randall Curtis

Abstract

To determine whether the dose of narcotics and benzodiazepines is associated with length of time from mechanical ventilation withdrawal to death in the setting of withdrawal of life-sustaining treatment in the ICU. Retrospective chart review. University-affiliated, level I trauma center. Consecutive critically ill patients who had mechanical ventilation withdrawn and subsequently died in the ICU during two study time periods. There were 75 eligible patients with a mean age of 59 years. The primary ICU admission diagnoses included intracranial hemorrhage (37%), trauma (27%), acute respiratory failure (27%), and acute renal failure (20%). Patients died during a median of 35 min (range, 1 to 890 min) after ventilator withdrawal. On average, 16.2 mg/h opiates in morphine equivalents and 7.5 mg/h benzodiazepine in lorazepam equivalents were administered during the time period starting 1 h before ventilator withdrawal and ending at death. There was no statistically significant relationship between the average hourly narcotic and benzodiazepine use during the 1-h period prior to ventilator withdrawal until death, and the time from ventilator withdrawal to death. The restriction of medication assessment in the last 2 h of life showed a...Continue Reading

Citations

Sep 1, 2005·Journal of Palliative Medicine·J Randall Curtis, Gordon D Rubenfeld
Feb 28, 2006·Journal of Palliative Medicine·J Randall Curtis
Aug 22, 2008·Journal of Palliative Medicine·Anne M WallingNeil S Wenger
Jan 1, 2009·Journal of Palliative Medicine·B Brent Simmons, Susan M Parks
Dec 20, 2007·Critical Care Medicine·Charles L SprungUNKNOWN ETHICUS Study Group
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Apr 24, 2008·Critical Care Medicine·Robert D TruogUNKNOWN American Academy of Critical Care Medicine
Sep 18, 2008·American Journal of Respiratory and Critical Care Medicine·Mohamed Y RadyJoan L McGregor
Apr 9, 2008·American Journal of Respiratory and Critical Care Medicine·Paul N LankenUNKNOWN ATS End-of-Life Care Task Force
May 14, 2009·International Journal of Chronic Obstructive Pulmonary Disease·Carl LlorUNKNOWN BRAMOX Study Group
Jan 10, 2014·International Journal of Critical Illness and Injury Science·Ur Rahman MasoodAmer Al Jundi
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