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New taxonomy for prolonged disorders of consciousness may help with decisions on withdrawal of clinically assisted nutrition and hydration: A proposed decision-making pathway

dc.contributor.authorTeixeira, Liliana da Conceição
dc.contributor.authorRocha, Nuno
dc.contributor.authorNunes, Rui
dc.date.accessioned2021-07-06T09:17:33Z
dc.date.available2021-07-06T09:17:33Z
dc.date.issued2021-04-19
dc.description.abstractThe number of patients surviving severe brain injury is increasing; however, many are left in a prolonged disorder of consciousness. With appropriate treatment, patients with prolonged disorders of consciousness can survive for years. Unless an advance directive exists, the treating clinicians can authorize withdrawal of clinically assisted nutrition and hydration for these patients, based on best interests. The classic terminology used in prolonged disorders of consciousness ranges from coma, vegetative state to minimally conscious state. However, a new group of patients with covert cognition has been identified in the last decade, making it necessary to revise the current taxonomy to better reflect our understanding of these conditions. With the introduction of a less ambiguous terminology, the challenges when it comes to withdrawal of clinically assisted nutrition and hydration of these patients may ease. A decision- making pathway for withdrawal of clinically assisted nutrition and hydration for patients with prolonged disorders of consciousness, based on a new taxonomy is proposed. These decisions should be based primarily on best interests. The adoption of a new classification for impairments of consciousness would clarify and improve how we think about these patients. Moreover, the development of accurate prognostic predictors would be a major step in the decision-making process, as it would influence the beneficent pathway towards the best clinical outcome.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationTeixeira, L. d. C. R., Nuno Barbosa; Nunes, Rui. (2021). New taxonomy for prolonged disorders of consciousness may help with decisions on withdrawal of clinically assisted nutrition and hydration: a proposed decision-making pathway. Journal of Rehabilitation Medecine, 53(5). https://doi.org/10.2340/16501977-2834pt_PT
dc.identifier.doi10.2340/16501977-2834pt_PT
dc.identifier.issn1651-2081
dc.identifier.urihttp://hdl.handle.net/10400.22/18084
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFoundation For Rehabilitation Informationpt_PT
dc.relation.publisherversionhttps://www.medicaljournals.se/jrm/content/html/10.2340/16501977-2834pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectClinically assisted nutrition and hydrationpt_PT
dc.subjectConsciousnesspt_PT
dc.subjectCovert cognitionpt_PT
dc.subjectDecision-makingpt_PT
dc.subjectMinimally conscious statept_PT
dc.subjectProlonged disorders of consciousnesspt_PT
dc.subjectVegetative statept_PT
dc.titleNew taxonomy for prolonged disorders of consciousness may help with decisions on withdrawal of clinically assisted nutrition and hydration: A proposed decision-making pathwaypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage7pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleJournal of Rehabilitation Medicinept_PT
oaire.citation.volume53pt_PT
person.familyNameRocha
person.givenNameNuno
person.identifier192266
person.identifier.ciencia-idAE16-A494-5F8B
person.identifier.orcid0000-0002-3139-2786
person.identifier.ridM-9821-2013
person.identifier.scopus-author-id32867975300
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication9e940914-601a-4978-8d5b-74e5ade7ada7
relation.isAuthorOfPublication.latestForDiscovery9e940914-601a-4978-8d5b-74e5ade7ada7

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