Why opioids and sedatives may prolong life rather than hasten death after ventilator withdrawal in critically ill patients

被引:20
作者
Bakker, Jan [1 ]
Jansen, Tim C. [1 ]
Lima, Alex [1 ]
Kompanje, Erxvin J. O. [1 ]
机构
[1] Erasmus MC Univ Med Ctr, Dept Intens Care, NL-3000 CA Rotterdam, Netherlands
关键词
palliative care; tissue hypoxia; opioids;
D O I
10.1177/1049909108315511
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The process of death in patients in whom cardiorespiratory Support is withdrawn is related to the occurrence of tissue hypoxia that results from an imbalance between the demand for oxygen and the delivery of oxygen to the organs. Limiting the demand for oxygen may thus delay the occurrence Of tissue hypoxia. Because the. demand for oxygen increases significantly after ventilator withdrawal and because sedatives and opioids are known to decrease the demand for oxygen in patients with cardiorespiratory distress, these agents might thus actually prolong life rather than hasten death.
引用
收藏
页码:152 / 154
页数:3
相关论文
共 11 条
[1]  
Bernard J M, 1988, J Clin Anesth, V1, P81, DOI 10.1016/0952-8180(88)90026-8
[2]  
BOCK AV, 1932, J CLIN INVEST, P11775
[3]   CRITICAL O2 TRANSPORT VALUES AT LOWERED BODY TEMPERATURES IN RATS [J].
CAIN, SM ;
BRADLEY, WE .
JOURNAL OF APPLIED PHYSIOLOGY, 1983, 55 (06) :1713-1717
[4]   APPEARANCE OF EXCESS LACTATE IN ANESTHETIZED DOGS DURING ANEMIC AND HYPOXIC HYPOXIA [J].
CAIN, SM .
AMERICAN JOURNAL OF PHYSIOLOGY, 1965, 209 (03) :604-&
[5]   Opioids and benzodiazepines appear paradoxically to delay inevitable death after ventilator withdrawal [J].
Edwards, MJ .
JOURNAL OF PALLIATIVE CARE, 2005, 21 (04) :299-302
[6]  
FIELD S, 1982, AM REV RESPIR DIS, V126, P9
[7]   MIDAZOLAM ATTENUATES THE METABOLIC AND CARDIOPULMONARY RESPONSES TO AN ACUTE INCREASE IN OXYGEN-DEMAND [J].
HARDING, J ;
KEMPER, M ;
WEISSMAN, C .
CHEST, 1994, 106 (01) :194-200
[8]   Care for the dying in intensive care in the Netherlands [J].
Kompanje, Erwin J. O. .
INTENSIVE CARE MEDICINE, 2006, 32 (12) :2067-2069
[9]   Mechanical ventilation in conjunction with the intra-aortic balloon pump improves the outcome of patients in profound cardiogenic shock [J].
Kontoyannis, DA ;
Nanas, JN ;
Kontoyannis, SA ;
Stamatelopoulos, SF ;
Moulopoulos, SD .
INTENSIVE CARE MEDICINE, 1999, 25 (08) :835-838
[10]   IDENTIFICATION OF THE CRITICAL OXYGEN DELIVERY FOR ANAEROBIC METABOLISM IN CRITICALLY ILL SEPTIC AND NONSEPTIC HUMANS [J].
RONCO, JJ ;
FENWICK, JC ;
TWEEDDALE, MG ;
WIGGS, BR ;
PHANG, PT ;
COOPER, DJ ;
CUNNINGHAM, KF ;
RUSSELL, JA ;
WALLEY, KR .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 270 (14) :1724-1730