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Entscheidungsgrundlagen in der Neurochirurgie

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Grenzsituationen in der Intensivmedizin
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Entscheidungen über Therapiebegrenzungen bei neurologisch-neurochirurgischen Patienten sind aufgrund der Unsicherheiten einer individuellen Prognose oft problematisch. Nur unter Würdigung der Gesamtsituation, insbesondere aber der Wünsche des Patienten für oder gegen ein Überleben mit schwerster funktionell-neurologischer Behinderung, kann für den Einzelfall eine ethisch vertretbare Entscheidung getroffen werden.

Für die Diskussion des Manuskriptes und ihre Anregungen bedanke ich mich bei meiner Frau, Fr. P. Kerz-Goertz, und Hr. Dr. R. Röder.

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Literatur

  1. Ragoschke-Schumm A, Pfeifer R, Marx G, Knoepffler N, Witte OW, Isenmann S: [Early evaluation of neurological prognosis and therapy after cardiopulmonary resuscitation: Current opportunities and clinical implications.]. Nervenarzt 2007, 78(8): 937–943

    Article  PubMed  CAS  Google Scholar 

  2. Zandbergen EG, Hijdra A, Koelman JH, Hart AA, Vos PE, Verbeek MM, de Haan RJ: Prediction of poor outcome within the first 3 days of postanoxic coma. Neurology 2006, 66(1): 62–68

    Article  PubMed  CAS  Google Scholar 

  3. Harvey JC: The burdens-benefits ratio consideration for medical administration of nutrition and hydration to persons in the persistent vegetative state. Christ Bioeth 2006, 12(1): 99–106

    Article  PubMed  Google Scholar 

  4. Salomon F: [Saving life and permitting death. Decision conflicts in intensive medicine]. Anaesthesist 2006, 55(1):64–69

    Article  PubMed  CAS  Google Scholar 

  5. Li LL, Cheong KY, Yaw LK, Liu EH: The accuracy of surrogate decisions in intensive care scenarios. Anaesth Intensive Care 2007, 35(1): 46–51

    PubMed  Google Scholar 

  6. Christakis NA, Lamont EB: Extent and determinants of error in doctors’ prognoses in terminally ill patients: prospective cohort study. Bmj 2000, 320(7233): 469–472

    Article  PubMed  CAS  Google Scholar 

  7. Andrews K, Murphy L, Munday R, Littlewood C: Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ 1996, 313(7048): 13–16

    PubMed  CAS  Google Scholar 

  8. Alvarez M, Nava JM, Rue M, Quintana S: Mortality prediction in head trauma patients: performance of Glasgow Coma Score and general severity systems. Crit Care Med 1998, 26(1): 142–148

    Article  PubMed  CAS  Google Scholar 

  9. Cho DY, Wang YC: Comparison of the APACHE III, APACHE II and Glasgow Coma Scale in acute head injury for prediction of mortality and functional outcome. Intensive Care Med 1997, 23(1): 77–84

    Article  PubMed  CAS  Google Scholar 

  10. Young JD: Severity scoring systems and the prediction of outcome from intensive care. Curr Opin Anaesthesiol 2000, 13(2): 203–207

    Article  PubMed  CAS  Google Scholar 

  11. Sinuff T, Adhikari NK, Cook DJ, Schunemann HJ, Griffith LE, Rocker G, Walter SD: Mortality predictions in the intensive care unit: comparing physicians with scoring systems. Crit Care Med 2006, 34(3): 878–885

    Article  PubMed  Google Scholar 

  12. Bundesärztekammer: Grundsätze der Bundesärztekammer zur ärztlichen Sterbebegleitung. Deut Ärzteblatt 2004, 101(19): A 1289–1289

    Google Scholar 

  13. DJT: Beschlüsse des 66. Deutschen Juristentags — Strafrecht. 2006: 24–36, www.djt.de

    Google Scholar 

  14. Neitzke G, Charbonnier R, Diemer W, May AT, Wernstedt T: Göttinger Thesen zur gesetzlichen Regelung des Umgangs mit Patientenverfügung und Vorsorgevollmacht. Med Ethik 2006, 18(2): 192–194

    Article  Google Scholar 

  15. Zahuranec DB, Brown DL, Lisabeth LD, Gonzales NR, Longwell PJ, Smith MA, Garcia NM, Morgenstern LB: Early care limitations independently predict mortality after intracerebral hemorrhage. Neurology 2007, 68(20): 1651–1657

    Article  PubMed  CAS  Google Scholar 

  16. Diringer MN, Edwards DF, Aiyagari V, Hollingsworth H: Factors associated with withdrawal of mechanical ventilation in a neurology/neurosurgery intensive care unit. Crit Care Med 2001, 29(9): 1792–1797

    Article  PubMed  CAS  Google Scholar 

  17. Mayer SA, Kossoff SB: Withdrawal of life support in the neurological intensive care unit. Neurology 1999, 52(8):1602–1609

    PubMed  CAS  Google Scholar 

  18. McLean RF, Tarshis J, Mazer CD, Szalai JP: Death in two Canadian intensive care units: institutional difference and changes over time. Crit Care Med 2000, 28(1): 100–103

    Article  PubMed  CAS  Google Scholar 

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Kerz, T. (2008). Entscheidungsgrundlagen in der Neurochirurgie. In: Junginger, T., Perneczky, A., Vahl, CF., Werner, C. (eds) Grenzsituationen in der Intensivmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-75820-4_8

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  • DOI: https://doi.org/10.1007/978-3-540-75820-4_8

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-75819-8

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