John S. is a 72-year-old patriarch of a large, extended family. He underwent a mitral and aortic valve replacement, followed by a complicated postoperative course. His recovery was complicated by hemodynamic instability, several cardiac arrests, acute renal failure, and sepsis. He has been in the ICU for 14 weeks and has been unable to wean from mechanical ventilation. After many conferences between the patient’s family and the ICU staff, a decision was made to remove ventilator support. This was done 3 days ago. John’s condition seems stable now, but it is clear that he will not regain his former state of health. He is very debilitated, may require chronic dialysis, and has suffered some anoxic brain damage during his arrests. The nursing and medical staff are now faced with the question of further withdrawal of treatment and are considering whether or not to discontinue his parenteral nutrition and all IV fluids.
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Limiting Care| May 01 1990
Withdrawal of Food and Fluid
Barbara J. Daly, RN, MSN, CCRN, FAAN
From University Hospitals of Cleveland and Case Western Reserve University, Cleveland, Ohio.
Reprint requests to Barbara J. Daly, RN, MSN, CCRN, FAAN, 3830 Bainbridge, Cleveland Heights, OH 44118.
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AACN Adv Crit Care (1990) 1 (1): 187–195.
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Barbara J. Daly; Withdrawal of Food and Fluid. AACN Adv Crit Care 1 May 1990; 1 (1): 187–195. doi: https://doi.org/10.4037/15597768-1990-1019
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