在痴呆症中移除左心室辅助装置:一个案例报告
Nicholas E Morley1, Cristina M Ramirez-Urquiola2, Shunichi Nakagawa2
1Emergency Medicine/Internal Medicine PGY-2, SUNY Downstate Medical Center and Kings County Hospital Center, Brooklyn, New York, New York, USA.
Journal of palliative medicine
|March 7, 2024
概括
本案例报告详细介绍了在一个缺乏决策能力的痴呆症患者中撤销左心室辅助器件 (LVAD) 治疗的情况. 它强调了伦理考虑和护理团队所学到的经验教训.
科学领域:
- 心脏病学 心脏病学
- 医学伦理 医学伦理
- 神经学 神经学
背景情况:
- 左心室辅助装置 (LVAD) 能够在医院外提供生命支持.
- 在认知障碍患者中管理LVAD存在独特的挑战.
研究的目的:
- 探索复杂的决策过程,在患有痴呆症的患者中撤销LVAD治疗.
- 分析指导在决策能力受到损害时取消生命支持的伦理原则.
主要方法:
- 案例报告的方法.
- 对对设备依赖患者生命终端护理的伦理准则的审查.
- 对跨学科团队商的分析.
主要成果:
- 患者尽管保持警觉,但由于痴呆症而缺乏决策能力.
- 顾问建议在LVAD戒断方面存在矛盾.
- 伦理原则指导最终决定撤回LVAD治疗.
结论:
- 在认知障碍患者中停止LVAD治疗需要仔细的伦理审议.
- 调整患者的价值观,家庭的愿望和医疗建议至关重要.
- 这个案例为LVAD接受者管理复杂的终生情景提供了有价值的见解.
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