Anaesthesia, critical care & pain medicine
Guidelines for Decisions to Withhold or Withdraw Life-Sustaining Treatments (LST) in Adult ICU
By Giabicani M, Audibert G, Atchade E and 19 others.
Abstract
Objective
The French Society of Anaesthesia and Intensive Care Medicine (Société française d'anesthésie et de réanimation, SFAR) and the French Society of Physical Medicine and Rehabilitation (Société Française de Médecine Physique et de Réadaptation (SOFMER)) aimed at providing guidelines for decisions to withhold or withdraw life-sustaining treatments (LST) in adult ICU.
Design
A consensus committee of 20 experts from the SFAR and the SOFMER was convened. A formal conflict-of-interest (COI) policy was developed at the beginning of the process and enforced throughout. The entire guideline construction process was conducted independently of any industrial funding (i.e., pharmaceutical, medical devices). The authors were required to follow the rules of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide the assessment of the quality of evidence. The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasized.