Frecuency of Do-Not-Resuscitate Orders in a Level 4 University Hospital

Fritz Eduardo Gempeler Rueda, Alejandra Sanín Hoyos, María De La Paz Echeverri Lombana, Angela Lucia Baloco Barrios, Ana María Parra Pérez


After the introduction of the cardiopulmonary resuscitation into clinical practice, non-resuscitation orders emerged as an alternative for those patients that, for several reasons, were not candidates to receive this type of medical treatment. Over time, the non-resuscitation orders have increased in number, possibly due to the aging of the population, an increase in the prevalence of oncological pathologies or greater awareness of the physicians regarding the outcomes of the patients being carried to a CPR. According to the above, this study was developed with the objective of knowing and describing the frequency of DNR and CPR in patients who died in a level 4 hospital in the city of Bogotá. Likewise, the demographic characteristics of these patients were described.

Palabras clave

bioethics; cardiopulmonary resuscitation; resuscitation orders


Burns JP, Edwards J, Johnson J, Cassem NH, Truog RD. Do-not-resuscitate order after 25 years. Crit Care Med. 2003;31:1543-50.

Mohr M, Kettler D. Ethical aspects of resuscitation. Br J Anaesth. 1997;79:253-9.

McBrien M, Heyburn G. Do not attempt resuscitation orders in the peri-operative period. Anaesthesia. 2006;61:625-7.

Gempeler F. Reanimación cardiopulmonar más allá de la técnica. Rev Colomb Anestesiol. 2015;43:142-6.

Angus DC, Successful resuscitation from in-hospital cardiac arrest–What happens next? JAMA. 2015;314:1238-9.

Diem SJ, Lantos JD, Tulsky JA. Cardiopulmonary resuscitation on television: Miracles and misinformation. N Engl J Med 1996;334:1578-82.

Guarisco KK. Managing do-not-resuscitate orders in the peri anesthesia period. J Perianesth Nurs. 2004;19:300-7.

Van Norman G. Do-not-resuscitate orders during anaesthesia and urgent procedures [Internet]. 1998. Available from:

Fritz Z, Fuld J. Ethical issues surrounding do not attempt resuscitation orders: decisions, discussion and deleterious effects. J Med Ethics. 2010;36:593-7.

Gan SC, Beaver SK, Houck PM. Treatment of acute myocardial infarction and 30- day mortality among women and men. N Engl J Med 2000;343:8-15.

Shepardson LB, Youngner SJ, Speroff T.Variation in the use of do-not-resuscitate orders in patients with stroke. Arch Intern Med. 1997;157:1841-7.

Phillips RS, Wenger NS, Teno J. Choices of seriously ill patients about cardio- pulmonary resuscitation: Correlates and outcomes. Am J Med 1996;100:128-37.

Torian LV, Davidson EJ, Fillit HM, Fulop G, Sell LL. Decisions for and against resuscitation in an acute geriatric medicine unit serving the frail elderly. Arch Intern Med. 1992;152:561-5.

Wenger NS, Pearson ML, Desmond KA. Epidemiology of do-not-resuscitate orders: Disparity by age, diagnosis, gender, race, and functional impairment. Arch Intern Med 1995;155:2056-62.

Van Delden JJ, van der Maas PJ, Pijnenborg L, Looman CW. Deciding not to resuscitate in Dutch hospitals. J Med Ethics. 1993;19:200-5.

De Gendt C, Bilsen J, Van Den Noortgate N, Lambert M, Stichele RV, Deliens L. Prevalence of patients with do-not-resuscitate status on acute geriatric wards in Flanders, Belgium. J Gerontol. 2007;62A:395-9.

Dautzenberg PL, Duursma SA, Bezemer PD, Van Engen C, Schonwetter RS, Hooyer C. Resuscitation decisions on a Dutch geriatric ward. Q J Med. 1993;86:535-42.

De Vos R, Koster RW, de Haan RJ. Impact of survival probability, life expectancy, quality of life and patient preferences on do-not-attempt-resuscitation orders in a hospital. Resuscitation Committee. Resuscitation. 1998;39:15-21.

Junod Perron N, Morabia A, De Torrente A. Evaluation of do not resuscitate orders (DNR) in a Swiss community hospital. J Med Ethics. 2002;28:36-7.

Youngner SJ, Lewandowski W, McClish DK, Juknialis BW, Coulton C, Bartlett ET. ‘Do not resuscitate’ orders. Incidence and implications in a medical-intensive care unit. JAMA. 1985;253:54-57.

Jayes RL, Zimmerman JE, Wagner DP, Draper EA, Knaus WA. Do-not-resuscitate orders in intensive care units. Current practices and recent changes. JAMA. 1993;270:2213-7.

Cherniack EP. Increasing use of DNR orders in the elderly worldwide: whose choice, is it? J Med Ethics. 2002;28:303-7.

Wachter RM, Luce JM, Hearst N, Decisions about resuscitation: inequities among patients with different diseases but similar prognoses. Ann Intern Med. 1989;111: 525-32.

Murphy DJ, Murray AM, Robinson BE, Campion EW. Outcomes of cardiopulmonary resuscitation in the elderly. Ann Intern Med. 1989;111:199-205.

Brindley PG. Perioperative do-not-resuscitate orders: It is time to talk. BMC Anesthesiology. 2013;13:1-3.

National Confidential Enquiry into Patient Outcome and Death (NCEPOD). Time to Intervene? A review of patients who underwent cardiopulmonary resuscitation as a result of an in-hospital cardiorespiratory arrest. Jun 2012 [cited 2014 May]. Available from:

Löfmark R, Nilstun T. Do-not-resuscitate orders-should the patient be informed? J Intern Med. 1997;241:1365-2796.

Gempeler FE, de Brigard-Pérez AM. Órdenes de no reanimación y anestesia. Rev Colomb Anestesiol. 2016;44:146-50.


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Copyright (c) 2018 Fritz Eduardo Gempeler Rueda, Alejandra Sanín Hoyos, María De La Paz Echeverri Lombana, Angela Lucia Baloco Barrios, Ana María Parra Pérez

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