<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0390</journal-id>
<journal-title><![CDATA[Revista Médica del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Méd. Urug.]]></abbrev-journal-title>
<issn>1688-0390</issn>
<publisher>
<publisher-name><![CDATA[Sindicato Médico del Uruguay]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-03902018000400005</article-id>
<article-id pub-id-type="doi">10.29193/rmu.34.4.1</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Características de la limitación de terapia de soporte vital en pacientes fallecidos en unidades de medicina intensiva]]></article-title>
<article-title xml:lang="en"><![CDATA[Characteristics of limiting life support therapies in patients who died in the ICU]]></article-title>
<article-title xml:lang="pt"><![CDATA[Características da limitação da terapia de suporte vital em pacientes falecidos em unidades de medicina intensiva]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Frache]]></surname>
<given-names><![CDATA[Bernardina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreira]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carámbula]]></surname>
<given-names><![CDATA[Agustín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pan]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barbato]]></surname>
<given-names><![CDATA[Marcelo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alzugaray]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Burghi]]></surname>
<given-names><![CDATA[Gastón]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Sanatorio Americano UCI ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Maciel, ASSE UCI ]]></institution>
<addr-line><![CDATA[Montevideo ]]></addr-line>
<country>Uruguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Sanatorio CAAMEPA UCI ]]></institution>
<addr-line><![CDATA[Canelones ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>34</volume>
<numero>4</numero>
<fpage>5</fpage>
<lpage>25</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-03902018000400005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-03902018000400005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-03902018000400005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción: la limitación de terapias de soporte vital (LTSV) es una práctica habitual y éticamente aceptada. La misma se enmarca en el concepto de adecuación del esfuerzo terapéutico.  Objetivo:  determinar la frecuencia, las directivas de implementación y los factores asociados a LSTV en los pacientes fallecidos en unidades de cuidados intensivos (UCI). Conocer la frecuencia y características del registro de este proceso en la historia clínica.  Diseño: estudio observacional multicéntrico de corte transversal.  Ámbito: se analizaron las historias clínicas de ocho UCI polivalentes públicas y privadas de Uruguay.  Pacientes: se incluyeron todos los pacientes mayores de 18 años fallecidos en un período de seis meses consecutivos en el año 2011.  Intervenciones: análisis de las características de los pacientes mediante revisión de historias clínicas.  Resultados: analizamos 210 pacientes fallecidos. Se identificó LSTV en 63 (30%). El 75% de las decisiones consistió en la retirada de medidas terapéuticas. Los factores independientemente asociados a LTSV fueron: mayor edad (OR 1,04 (IC 95% 1,01-1,07), p = 0,001), mayor estadía en UCI (OR 1,06 (IC 95% 1,02 - 1,11), p = 0,001) y limitación para las actividades de la vida diaria (OR 4,65 (IC 95% 1,1-19,6), p=0,035). El 70% de las directivas LTSV fueron registradas en la historia clínica. Los soportes vitales más frecuentemente retirados fueron: nutrición parenteral (100%), vasopresores (79%), nutrición enteral (64%) y antimicrobianos (52%). La asistencia ventilatoria mecánica invasiva se retiró en el 33% de los casos.  Conclusiones: un tercio de los pacientes fallece con LTSV. Este tipo de decisiones se asocian a mala calidad de vida previa, mayor edad y mayor estadía en UCI. Un tercio de las decisiones de LTSV no son registradas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction: withdraw and withhold life support therapies is an usual and ethically accepted practice.  Objectives: to determine the frequency, the directives and factors associated with withdrawing and withholding life support therapies in patients who died in ICU. Determine the frequency and characteristics of the record of this process in clinical history.  Design: multicentric observational study of cross section.  Setting: clinical histories of 8 public and private mixed ICUs in Uruguay were analyzed.  Patients: all patients over 18 years who died in a period of 6 consecutive months in 2011 were included.  Interventions:  analysis of the characteristics of patients through review of clinical histories.  Results:  we analyzed 210 patients who died. Withdrawing or withholding was identified in 63 (30%). 75% of the decisions consisted in withdraw therapeutic measures. Factors independently associated to withdrowing or withholding therapies were: an older age (OR 1.04 (95% CI 1.01-1.07), p = 0.001), a longer stay in ICU (OR 1.06 (95% CI 1, 02 - 1.11), p = 0.001), and the limitation for activities of daily living (OR 4.65 (95% CI 1.1 -19.6), p = 0.035). 70% of the decisions were recorded in the clinical history. The most frequently removed vital supports were: parenteral nutrition (100%), vasopressors (79%), enteral nutrition (64%) and antimicrobials (52%). Invasive mechanical ventilatory assistance was removed in 33% of the cases.  Conclusions: one third of patients die with LSTL. These types of decisions are associated with a poor quality of life, an older age and a longer stay in the ICU. One third of LTSV decisions are not registered.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo:  Introdução: a limitação do emprego de terapias de suporte vital (LTSV) é uma prática habitual e eticamente aceitada. Esta decisão está compreendida no conceito de adequação do esforço terapêutico.  Objetivos: determinar a frequência, as normas de implementação e os fatores associados à LSTV nos pacientes falecidos em unidades de cuidados intensivos (UCI). Conhecer a frequência e as características do registro deste processo no prontuário do paciente.  Tipo de estudo: estudo observacional multicêntrico de corte transversal.  Escopo: foram analisados os prontuários dos pacientes de 8 UCIs polivalentes públicas e privadas do Uruguai.  Pacientes: foram incluídos todos os pacientes maiores de 18 anos falecidos em um período de 6 meses consecutivos em 2011.  Intervenções: análise das características dos pacientes pela revisão dos prontuários dos pacientes.  Resultados: analisamos 210 pacientes falecidos. Em 63 (30%) pacientes foi registrada a LTSV. 75% das decisões consistiam na retirada de medidas terapêuticas. Os fatores independentemente associados a LTSV foram: idade mais avançada (OR 1,04 (IC 95 % 1,01-1,07), p = 0,001), maior permanência na UCI (OR 1,06 (IC 95% 1,02 - 1,11), p = 0,001), e limitação para as atividades da vida diária (OR 4,65 (IC 95% 1,1 -19,6), p=0,035). 70% das diretivas LTSV foram registradas no prontuário do paciente. Os suportes vitais mais frequentemente retirados foram: nutrição parenteral (100%), vasopressores (79%), nutrição enteral (64%) e antimicrobianos (52%). A assistência ventilatória mecânica invasiva foi retirada em 33% dos casos.  Conclusões: um terço dos pacientes falece com LTSV. Este tipo de decisão está associada à má qualidade de vida previa, idade mais avançada e maior permanência em UCI. Um terço das decisões de LTSV não é registrado.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Privación de tratamiento]]></kwd>
<kwd lng="es"><![CDATA[Unidades de cuidados intensivos]]></kwd>
<kwd lng="es"><![CDATA[Cuidado terminal]]></kwd>
<kwd lng="es"><![CDATA[Toma de decisiones]]></kwd>
<kwd lng="en"><![CDATA[Withholding treatment]]></kwd>
<kwd lng="en"><![CDATA[Intensive care units]]></kwd>
<kwd lng="en"><![CDATA[Terminal care]]></kwd>
<kwd lng="en"><![CDATA[Decision making]]></kwd>
<kwd lng="pt"><![CDATA[Privação de tratamento]]></kwd>
<kwd lng="pt"><![CDATA[Unidades de terapia intensiva]]></kwd>
<kwd lng="pt"><![CDATA[Cuidado terminal]]></kwd>
<kwd lng="pt"><![CDATA[Toma de decisões]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Walling]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Asch]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Lorenz]]></surname>
<given-names><![CDATA[KA]]></given-names>
</name>
<name>
<surname><![CDATA[Roth]]></surname>
<given-names><![CDATA[CP]]></given-names>
</name>
<name>
<surname><![CDATA[Barry]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Kahn]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The quality of care provided to hospitalized patients at the end of life]]></article-title>
<source><![CDATA[Arch Intern Med]]></source>
<year>2010</year>
<volume>170</volume>
<page-range>1057-63</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fumis]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
<name>
<surname><![CDATA[Deheinzelin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Respiratory support withdrawal in intensive care units families, physicians and nurses views on two hypothetical clinical scenarios]]></article-title>
<source><![CDATA[Crit Care]]></source>
<year>2010</year>
<volume>14</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>R235</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rapin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Le Gall]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Palliative comfort therapy in critically ill patients]]></article-title>
<source><![CDATA[Bull Acad Nat Med]]></source>
<year>1979</year>
<volume>163</volume>
<page-range>566-71</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rapin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Le Gall]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Raphaël]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Limitations of resuscitation]]></article-title>
<source><![CDATA[Acquis Med Recent]]></source>
<year>1981</year>
<volume>198</volume>
<page-range>7-17</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Smedira]]></surname>
<given-names><![CDATA[NG]]></given-names>
</name>
<name>
<surname><![CDATA[Evans]]></surname>
<given-names><![CDATA[BH]]></given-names>
</name>
<name>
<surname><![CDATA[Grais]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[NH]]></given-names>
</name>
<name>
<surname><![CDATA[Lo]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Cooke]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Withholding and withdrawal of life support from the critically ill]]></article-title>
<source><![CDATA[N Eng J Med]]></source>
<year>1990</year>
<volume>322</volume>
<page-range>309-15</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bandrauk]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Downar]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Paunovic]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Withholding and withdrawing life- sustaining treatment The Canadian Critical Care Society position paper]]></article-title>
<source><![CDATA[Can J Anaesth]]></source>
<year>2018</year>
<volume>65</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>105-22</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yaguchi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Truog]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Curtis]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Luce]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Levy]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Mélot]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[International differences in end-of-life attitudes in the intensive care unit]]></article-title>
<source><![CDATA[Arch Intern Med]]></source>
<year>2005</year>
<volume>165</volume>
<page-range>1970-5</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cuttini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Nadai]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kaminski]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hansen]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[de Leeuw]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Lenoir]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endof-life decisions in neonatal intensive care physicians' self reported practices in seven European countries. EURONIC Study Group]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2000</year>
<volume>355</volume>
<page-range>2112-8</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sprung]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[Eidelman]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Worldwide similarities and differences in the forgoing of life-sustaining treatments]]></article-title>
<source><![CDATA[Intensive Care Med]]></source>
<year>1996</year>
<volume>22</volume>
<page-range>1003-5</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lobo]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Simoni]]></surname>
<given-names><![CDATA[FHB]]></given-names>
</name>
<name>
<surname><![CDATA[Jakob]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Estella]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Vadi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bluethgen]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Decision-making on withholding or withdrawing life-support in the ICU a worldwide perspective]]></article-title>
<source><![CDATA[Chest]]></source>
<year>2017</year>
<volume>152</volume>
<page-range>321-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Devictor]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Tissieres]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Gillis]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Robert Truog]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Intercontinental differences in end-of-life attitudes in the pediatric intensive care unit results of a worldwide survey]]></article-title>
<source><![CDATA[Pediatr Crit Care Med]]></source>
<year>2008</year>
<volume>9</volume>
<page-range>560-6</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Piva]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Lago]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Othero]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Garcia]]></surname>
<given-names><![CDATA[PC]]></given-names>
</name>
<name>
<surname><![CDATA[Fiori]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Fiori]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluating end of life practices in ten Brazilian paediatric and adult intensive care units]]></article-title>
<source><![CDATA[J Med Ethics]]></source>
<year>2010</year>
<volume>36</volume>
<page-range>344-8</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moritz]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Deicas]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Capalbo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Forte]]></surname>
<given-names><![CDATA[DN]]></given-names>
</name>
<name>
<surname><![CDATA[Kretzer]]></surname>
<given-names><![CDATA[LP]]></given-names>
</name>
<name>
<surname><![CDATA[Lago]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[II Forum of the "End of Life Study Group of the Southern Cone of America" palliative care definitions, recommendations and integrated actions for intensive care and pediatric intensive care units]]></article-title>
<source><![CDATA[Rev Bras Ter Intensiva]]></source>
<year>2011</year>
<volume>23</volume>
<page-range>24-9</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Azoulay]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Metnitz]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Sprung]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[Timsit]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
<name>
<surname><![CDATA[Lemaire]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[End-of-life practices in 282 intensive care units data from the SAPS 3 database]]></article-title>
<source><![CDATA[Intensive Care Med]]></source>
<year>2009</year>
<volume>35</volume>
<page-range>623-30</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sprung]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[Carmel]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sjokvist]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Baras]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Maia]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Attitudes of European physicians, nurses, patients, and families regarding end-of-life decisions the ETHICATT study]]></article-title>
<source><![CDATA[Intensive Care Med]]></source>
<year>2007</year>
<volume>33</volume>
<page-range>104-10</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Blazquez]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Sandiumenge]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Oliver]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Cancio]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Ibanez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factors related to limitation of life support within 48 h of intensive care unit admission: a multicenter study]]></article-title>
<source><![CDATA[Med Intensiva]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wynn]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wise]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Wright]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Rafaat]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[YZ]]></given-names>
</name>
<name>
<surname><![CDATA[Steeb]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Accuracy of administrative and trauma registry databases]]></article-title>
<source><![CDATA[J Trauma]]></source>
<year>2001</year>
<volume>51</volume>
<page-range>464-8</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spronk]]></surname>
<given-names><![CDATA[PE]]></given-names>
</name>
<name>
<surname><![CDATA[Kuiper]]></surname>
<given-names><![CDATA[AV]]></given-names>
</name>
<name>
<surname><![CDATA[Rommes]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Korevaar]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Schultz]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The practice of and documentation on withholding and withdrawing life support a retrospective study in two Dutch intensive care units]]></article-title>
<source><![CDATA[Anesth Analg]]></source>
<year>2009</year>
<volume>109</volume>
<page-range>841-6</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mani]]></surname>
<given-names><![CDATA[RK]]></given-names>
</name>
<name>
<surname><![CDATA[Mandal]]></surname>
<given-names><![CDATA[AK]]></given-names>
</name>
<name>
<surname><![CDATA[Bal]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Javeri]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Kumar]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Nama]]></surname>
<given-names><![CDATA[DK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[End-of-life decisions in an Indian intensive care unit]]></article-title>
<source><![CDATA[Intensive Care Med]]></source>
<year>2009</year>
<volume>35</volume>
<page-range>1713-9</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Long]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Muni]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Treece]]></surname>
<given-names><![CDATA[PD]]></given-names>
</name>
<name>
<surname><![CDATA[Engelberg]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Nielsen]]></surname>
<given-names><![CDATA[EL]]></given-names>
</name>
<name>
<surname><![CDATA[Fitzpatrick]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Time to death after terminal withdrawal of mechanical ventilation specific respiratory and physiologic parameters may inform physician predictions]]></article-title>
<source><![CDATA[J Palliat Med]]></source>
<year>2015</year>
<volume>18</volume>
<page-range>1040-7</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gerstel]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Engelberg]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Koepsell]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Curtis]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Duration of withdrawal of life support in the intensive care unit and association with family satisfaction]]></article-title>
<source><![CDATA[Am J Respir Crit Care]]></source>
<year>2008</year>
<volume>178</volume>
<page-range>798-804</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
