Description : Purpose: in France, death after decision to withdrawal or withholding sustaining life
therapies concerns about 10% of intensive care unit (ICU) patients. Clayes-Leonetti
law published in 2016 intend to frame our medical exercise. The purpose of this study
is to review the current practice concerning end of life (EOL) management in French
ICU. br Methods: two national surveys were conduct, the first one consisted in 30
multiple choices questions about epidemiology, EOL decisions making, care organization
and self opinion sent by mail to senior physicians members of Société Française d’Anesthésie
Réanimation (SFAR). Evaluation of practices on analgesia and sedation was conduct
with two clinical cases. The second survey consisted in 24 multiples choices questions
sent by mail to residents members of SFAR jeunes. br Results: between October 2016
and October 2017, 695 physicians participated to the study. They majority work in
a medico surgical unit in an University Center. Withholding and withdrawal life sustaining
therapies decisions occur after collegial meeting (88%), a third doesn’t report decision
in medical record, 46% always include medical third in decision making and only a
third of physicians collect anticipate directive. Majority of them continue support
care on these patients. In half of cases they haven’t sedation and analgesia protocol.
Only 5% of physicians are completely satisfied of EOL care, where a better pain monitoring
support is expected. br Conclusion: heterogeneity for EOL management is important
between physicians, we need to improve care and set up protocols to help physicians
particularly concerning analgesia and sedation.;
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