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Ethical Issues in Dialysis
Aaron Spital, Series Editor: Cardiopulmonary Resuscitation and Dialysis: Outcome and Patients' Views
Author(s) -
Hijazi Fadi,
Holley Jean L.
Publication year - 2003
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1046/j.1525-139x.2003.03012.x
Subject(s) - medicine , cardiopulmonary resuscitation , dialysis , intensive care medicine , resuscitation , cardiorespiratory arrest , advance care planning , intervention (counseling) , emergency medicine , surgery , nursing , palliative care
Cardiopulmonary resuscitation (CPR) was initially described as an intervention to be used in otherwise healthy individuals suffering acute cardiorespiratory arrest. Over the years, CPR has been extended to all hospitalized patients unless specific orders not to resuscitate have been written with the informed consent of the patient and/or surrogate. The 14–15% survival to hospital discharge reported for in‐hospital CPR has not changed over the past three decades. Compared with other diseases, chronic kidney disease reduces long‐term survival (more than 6 months) following CPR, and the functional status of the few who survive is often quite poor. Nevertheless, most dialysis patients want to be resuscitated. Unfortunately television shows portraying resuscitation imply that survival after CPR is much more common than it really is. Such misinformation contributes to the overwhelming choice for CPR despite the dismal prognosis. Dialysis unit staff need to educate patients and families about the expected success and complications of CPR as part of the advance care planning process that should now be routine.