[Limits and Ethics of Mechanical Ventilation and Intensive Care Medicine in Old Age].

[Limits and Ethics of Mechanical Ventilation and Intensive Care Medicine in Old Age]. Pneumologie. 2021 Feb;75(2):142-155 Authors: Schönhofer B, Barchfeld T, Geiseler J, Heppner HJ Abstract Changing demography with more older people and more patients with chronic diseases as well as the progress of medicine leads to more geriatric patients treated in intensive care and requiring mechanical ventilation due to severe respiratory insufficiency.Frailty is associated with a more complicated intensive care stay, more difficult convalescence and with a higher mortality.In principle, geriatric expertise should be brought in as early as possible in the course of intensive care treatment for older patients in order to carry out adequate risk stratification and, depending on the extent of the impairment, to plan discharge or early rehabilitation.In older and frail patients preexisting chronic ventilatory insufficiency often leads to prolonged weaning. Patients with weaning failure should be referred to a specialized weaning center. Part of the assessment will be whether out-of-hospital invasive or non invasive ventilation is indicated and the wish of the patient.In intensive care the likelihood of a successful outcome and the patient's wishes must constantly be re-evaluated. This is particularly true in older patients. In addition it should be clarified with the patients and relatives what constitutes "success"; for example a patient may consi...
Source: Pneumologie - Category: Respiratory Medicine Tags: Pneumologie Source Type: research