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Life Support Issues/End of Life for Cirrhosis


Disease: Cirrhosis of the Liver - end stage.
My brother was admitted to the hospital with massive bleeding from the throat, stomach and bowels. He has had his circulatory blood completely replaced plus. Right now his count is at 9.4 and holding along with stable vitals. My concern is that he now has congestive heart failure and the doctors think he has pneumonia. Toady a procedure to remove fluid from his abdomen was done. Yesterday he was being backed off the vent and sedation stopped - today this has happened and he has been sedated again and still on the vent. Is this common with this disease and what other complications can we expect as we near the end? I understand no one knows when someone is going to pass but I feel there are signs that tell us at what stage we are in this process.
Thank you

I am really sorry that your family has to go through such a difficult process with your brother. My experience has been that some patient's survive for a very short time. Once organs begin to fail they continue to fail but it may not be rapid. What you describe is commonly seen.
Consider that his heart is failing, his liver is failing and probably also his kidneys.
The complications that you are seeing will continue. The hospital is an artificial environment so it is difficult to tell you his exact medical course because the hospital will treat with every change in his condition. Here are some thoughts for you.
Have you obtained a do not resuscitate order for him?  It is unlikely he will meaningfully  recover after resuscitation.
Have you had an opportunity to say "goodbye"? You would do this for you than for him. He has struggled with a lifelong addiction, which is not his fault, but it has affected everyone who loves him.
I wish your family peace during this process.  

Life Support Issues

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Betsy Murphy


My expertise is in end of life care for adults. Identifying when someone is approaching the end of their life. Benefits and burdens of end of life treatments. Managing pain and other symptoms. Providing care for dying patients at home. Advocating for someone who is dying in a hospital or nursing home.


More than 28 years of experience in hospice care. Currently consulting with hospices to promote access for patients to receive hospice care earlier in the course of their illness. Betsy provides training for hospice marketing staff to effectively work with nursing facilities to help identify eligible patients. She writes Additional Development Request (ADR) letters to Medicare to help hospices get paid for their services and to avoid future claim denials.

Hospice and Palliative Nurses Association

Articles: Clinical Reviews, Advance for Nurses, Nursing Spectrum, Washington Business Woman,; Understanding Medical-Surgical Nursing (FA Davis and Company), Guide to Caregiving in the Final Months of Life (TM Brown publishers).

Bachelors of Science in Nursing, additionally trained as a Family Nurse Practitioner and certified as a hospice and palliative care nurse.

Awards and Honors
Outstanding Woman in Loudoun County (VA) by Loudoun County Commission on Women 1997 and 2002.

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