The decision to withdraw life support from patients with severe brain injuries is very difficult. In a study conducted in Canadian Medical Association Journal, critical care physicians were asked about the decision-making process when it comes to withdrawing life-sustaining treatment.

The study identified clinically useful information about the processes surrounding level-of-care decisions for the early care of critically ill patients with severe traumatic brain injury (TBI). Identifying clear determinants involved in this process should help to improve how physicians make recommendations to withdraw life-sustaining treatments in this population.

The study has implications for the care of critically ill patients with severe traumatic brain injury and can inform policy implementation to improve our approach to the evaluation of prognosis and level-of-care decisions in this population.

104 critical care physicians were approached to recruit 20 participants between November 2015 and March 2016. The distribution of participants across the 4 Canadian geographic regions was similar through the use of our sampling strategy. Most participants were male, born in Canada, had 10 years of experience or less, and spent between 10 and 20 weeks per year in the ICU.

Future research should aim at identifying the factors influencing surrogate decision-makers in the decision to withdraw life-sustaining treatments in critically ill patients with severe traumatic brain injury.

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