Evaluation of the appropriateness of termination of CRRT in ICU death cases

Abstract

【Background】Continuation of CRRT may extend the time to death but may not necessarily be a treatment that meets the patient’s and family’s will and wishes when the patient is not able to survive without CRRT. We evaluated the appropriateness of CRRT termination in ICU death cases. 【Methods】Among CRRT patients who stayed in the ICU for seven days or more, the timing of CRRT termination and the duration from the end of CRRT to death were examined in death cases. 【Results】Of sixty-five patients, CRRT was terminated in seventeen patients (26%) before death. CRRT was terminated after informed consent from the patient’s family following a conference by multi-occupations about the patient’s condition. The median duration from CRRT termination to death was 201 minutes. 【Discussion & conclusion】Different from ventilators and assisted circulators, the termination of CRRT is less likely to lead directly to death of the patient. If deterioration of the patient’s condition has been suppressed by CRRT, however, termination of CRRT may define the time to death. When a patient is considered to be in the terminal stage of disease, we should present the possibility of being unable to save life, and support to allow time for the family to be fully convinced.