A new study presented at the European Respiratory Society Annual Congress in Amsterdam showed that patients with chronic conditions may change their preferences for receiving emergency procedures in the event of cardiac arrest. Research reveals that different factors could have an impact on influencing patients’ decisions to undergo life-sustaining treatments, a fact often overlooked by health care providers.
Cardiopulmonary resuscitation (CPR) is an emergency procedure that has the potential to re-animate a person in cardiac arrest by applying rhythmic chest compressions in an effort to preserve intact brain function until further measures are taken to restore spontaneous blood circulation. Those patients who stop or have problems breathing spontaneously are aided by mechanical ventilation (artificial respiration).
Patients diagnosed with a potentially life-limiting illness may decide in advance whether or not they agree to these procedures in the event of a cardiac arrest once they discussed the issue with their doctor.
Researchers wanted to establish patients’ preferences towards these life-saving procedures and conducted a study on 206 patients who suffered from chronic obstructive pulmonary disease (COPD), chronic heart failure or chronic renal failure but were in a stable condition at the start of the study. Patients were monitored every four months for a year with their preferences for CPR and mechanical ventilation was assessed.
By assessing various health and lifestyle factors, such as presence of other diseases, hospital admission, health status, care dependency, mobility, depression and anxiety, researchers were able to establish whether these factors could be linked with changes in patients’ preferences for life-sustaining treatments.
The study revealed that 38% of people changed their preferences for CPR and / or mechanical ventilation over the year. The researchers also established that patients were more inclined to change their preferences if they experienced a change in health status, mobility, symptoms of anxiety and depression or marital status.
These findings imply a significant impact for clinical care as healthcare providers need to be aware of these preferences, and should evaluate them regularly.
Dr Daisy Janssen, lead author from the CIRO+, Centre of Expertise for Chronic Organ Failure in the Netherlands concluded:
“Our findings have given us a key insight into how patients’ preferences change regarding life-sustaining treatments. We suggest that regular re-evaluation of advance care planning is necessary when patients experience a change in health status, mobility, symptoms of anxiety and depression or marital status.”
Written by Petra Rattue