Evidence map›Paper›PMID 31549266›Full record

ReviewAnnals of intensive care2019

Withholding and withdrawing life-support in adults in emergency care: joint position paper from the French Intensive Care Society and French Society of Emergency Medicine.

Jean Reignier, Anne-Laure Feral-Pierssens, Thierry Boulain, Françoise Carpentier, Pierrick Le Borgne, Denis Del Nista, Gilles Potel, Sandrine Dray, Delphine Hugenschmitt, Alexandra Laurent and 4 more

Open access · goldAbstract readReview
In one paragraph

Review in Annals of intensive care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
4.4field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 27 citations in OpenAlex.

  1. Observational
  2. Article
  3. Observational
  4. Article
  5. Article
  6. Observational
  7. Review
  8. Article
  9. Article
  10. Management of decision of withholding and withdrawing life-sustaining treatments in French EDs.Scandinavian journal of trauma, resuscitation and emergency medicine · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 10 institutions in 1 country.

Jean ReignierService de Médecine Intensive Réanimation, Centre Hospitalier Universitaire Hotel-Dieu, 30 Bd. Jean Monnet, 44093, Nantes Cedex 1, France. jean.reignier@chu-nantes.fr.
Anne-Laure Feral-PierssensAssistance Publique Hôpitaux de Paris, Service des Urgences, Hôpital Européen Georges Pompidou Paris, Paris, France.
Thierry BoulainService de Réanimation Médicale Polyvalente, Centre Hospitalier Régional Orléans, Orléans, France.
Françoise CarpentierPôle Urgences Médecine Aigüe, Hôpital Universitaire des Alpes, Grenoble, France.
Pierrick Le BorgneService d'Accueil des Urgences, Hôpital de Hautepierre, CHRU Strasbourg, Strasbourg, France.
Denis Del NistaService des Urgences, CH de Rochefort, Rochefort, France.
Gilles PotelUniversité de Nantes, Nantes, France.
Sandrine DrayService de Réanimation Médicale, Hôpital Nord, CHU de Marseille, Marseille, France.
Delphine HugenschmittSAMU-SMUR de Lyon, Hospices Civils de Lyon, Lyon, France.
Alexandra LaurentLaboratoire Psy-DREPI, Université de Bourgogne Franche-Comté, EA7458, Dijon, France.
Agnès Ricard-HibonSAMU-SMUR 95- Service des Urgences, Centre Hospitalier René Dubos, Pontoise, France.
Thierry VanderlindenService de Réanimation Polyvalente, Groupe Hospitalier Institut Catholique de Lille/Faculté Libre de Médecine/Université Lille Nord de France, Lille, France.
Tahar ChouihedSAMU-SMUR-Service d'Urgences, Hôpital Central, CHRU Nancy, Vandoeuvre les Nancy, France.
French Society of Emergency Medicine (Société Française de Médecine d’Urgence, SFMU) and French Intensive Care Society (Société de Réanimation de Langue Française, SRLF)
Centre Hospitalier Universitaire de Nantes · FRCentre Hospitalier Universitaire de Grenoble · FRUniversité de Bourgogne · FRAssistance Publique – Hôpitaux de Paris · FRCentre Hospitalier de Rochefort · FRCentre Hospitalier Régional et Universitaire de Nancy · FRGroupe Hospitalier de l'Institut Catholique de Lille · FRHospices Civils de Lyon · FRInserm · FRNantes Université · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

For many patients, notably among elderly nursing home residents, no plans about end-of-life decisions and palliative care are made. Consequently, when these patients experience life-threatening events, decisions to withhold or withdraw life-support raise major challenges for emergency healthcare professionals. Emergency department premises are not designed for providing the psychological and technical components of end-of-life care. The continuous inflow of large numbers of patients leaves little time for detailed assessments, and emergency department staff often lack training in end-of-life issues. For prehospital medical teams (in France, the physician-staffed mobile emergency and intensive care units known as SMURs), implementing treatment withholding and withdrawal decisions that may have been made before the acute event is not the main focus. The challenge lies in circumventing the apparent contradiction between the need to make immediate decisions and the requirement to set up a complex treatment project that may lead to treatment withholding and/or withdrawal. Laws and recommendations are of little assistance for making treatment withholding and withdrawal decisions in the emergency setting. The French Intensive Care Society (Société de Réanimation de Langue Française, SRLF) and French Society of Emergency Medicine (Société Française de Médecine d'Urgence, SFMU) tasked a panel of emergency physicians and intensivists with developing a document to serve both as a position paper on life-support withholding and withdrawal in the emergency setting and as a guide for professionals providing emergency care. The task force based its work on the available legislation and recommendations and on a review of published studies.

Identifiers

PMID31549266
PMCPMC6757069
OpenAlexW2976046805

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.