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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, today’s tip is about multiple organ failure in intensive care and if life support should be switched off if there’s multiple organ failure? So, I have a very quick email from a reader who says, “My partner is in intensive care with multiple organ failure. He’s on life support and he needs his leg amputated. They want to switch his machines off instead. What should I do?”

Well, you haven’t said how old your partner is but irrespective of that, no life support in intensive care should ever switched off without patient or family consent. Just because the intensive care team suggests that life support should be switched off, doesn’t mean you need to agree to it, or your partner needs to agree to it even though it sounds like your partner may not be in a position that he can agree to it if he’s in multiple organ failure and on life support.

Now, when someone is in multiple organ failure in intensive care that could mean a number of things. I’ll tell you most common scenarios in intensive care what is considered multiple organ failure. When someone is on a ventilator and is not breathing, that is considered life support. So, the lungs would be failing. If someone is on inotropes/vasopressors, or on vasodilators even, because their blood pressure is either too high or too low, that is considered life support. If someone is getting multiple blood transfusions for whatever reason, that is considered life support. It also means that if vasopressors are needed, blood transfusions are needed, it means that the heart is often failing and that is another form of life support.

Now, in intensive care, sometimes the kidneys are failing and then hemofiltration or dialysis needs to be started so that the function of the kidney can be taken over, that is also considered life support and it’s considered organ failure for the kidneys. Also, the liver might be failing and then that could be considered life support.

You could also argue that if someone gets enteral nutrition via a nasogastric tube, via a PEG (percutaneous endoscopic gastrostomy) tube, even via central line, via TPN (total parenteral nutrition), one could argue that’s also considered life support and it’s also considered organ failure. Someone can’t swallow, their digestive tract is not working. Then lastly, if the brain is not working, that could also be considered as organ failure.

So, let’s just say all organs are failing, should someone be taken off life support? I strongly argue because that’s what intensive care units are there for – to save lives and restore organ function. Once again, approximately 90% of intensive care patients survive and that is despite multiple organ failure often. It can take some time but surely you, as a family, you want to have some say when and if life support should be withdrawn or not.

Now, I know you have the challenge here that your partner most likely needs a leg amputation on top of everything that’s going on, but the question is, what do you want? What does your partner want? Does he want to live even if he needs his leg amputated? I can’t answer that question for you but what you need to know is as long as there’s life, there is hope. Quality of life is just the perception; I should say future quality of life is just the perception. It’s just that what is a good quality of life for someone or for you may not be what I’m thinking is a good quality of life and vice versa.

So, think about what is important for you, what is important for your partner. Is the outlook of death a good one? Is the outlook of a lengthy recovery a good one? With all the side effects that come from that, but that’s probably a better option than dying, and maybe let your partner get to a point where he can make his own decision. I’m a big believer that people should make their own decisions and those decisions about life or death should not be triggered by intensive care teams no matter how bad the odds in theory.

So, you got to see how the next few days unfold. Are the organs recovering? Are they doing everything within their power to restore organ function? That’s another very important question. They may want to switch off life support and they may not have even offered you all therapy options as yet.

Again, the biggest challenge for families in intensive care is that they don’t know what they don’t know. They don’t know what to look for. They don’t know what questions to ask. They don’t know their rights and they don’t know how to manage doctors and nurses in intensive care, and that’s, I believe what you are dealing with.

You probably don’t even know half of the things that are going on and you probably don’t even know half of the treatment options that are available for your loved one, for your partner, to get him out of intensive care alive. That’s why you should simply talk to us so we can give you a second opinion and we can shed some light on the situation, so you’re not bogged down by this doom and gloom situation.

Have a look at the podcast that I’ve done couple of weeks ago with one of our clients, where I interviewed an ICU survivor. At the time, the client was basically doomed to die in ICU, and he would have died if the family had given in and if they hadn’t reached out to me. I was obviously intervening with the intensive care team. I was successfully advocating and about 12 months later, this gentleman is sitting on a podcast, sharing his story that him and his family are forever grateful that we could turn this situation around and making sure that he can live, otherwise he would have just passed away.

The title of the podcast is, “Thank you Intensive Care Hotline for saving my life. You are light and guidance to people”. So, check out this podcast just to verify everything that I’m saying that you should not give up here, it’s way too early.

If your partner cannot survive despite all treatment options being offered and thrown at him, then that’s a different story. That would then be considered a real end of life situation. But if other treatment options are offered and you don’t know about them yet, that is then a perceived end of life situation. They are thinking he might be dying, but not all options have been offered or are performed.

So, reach out to us, we can help you with this very quickly. If you have a loved one in intensive care, please contact us at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.

Also, have a look at our membership for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, in a membership area and via email and we answer all questions intensive care related.

If you need a medical record review and a second opinion in real time, please contact us as well. We review medical records in intensive care in real time and we can give you a second opinion very fast. I also offer one-to-one consulting and advocacy with doctors and nurses directly talking to them, directly talking to you of course, you as the client. We can also represent you in family meetings with intensive care teams and, again, give you that second opinion and hold intensive care teams accountable. If you need a medical record review after intensive care, if you are suspecting medical negligence, if you have unanswered questions, or if you are simply suspecting medical negligence, please contact us as well.

Subscribe to my YouTube channel for regular updates for families in intensive care, click the like button, click the notification bell, and comment below what you want to see next or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.

Take care for now.

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