3.18.2005

CNN.com - What happens to patients without feeding tubes - Mar 18, 2005

(AP) -- According to LifePath Hospice, this is the general process of death for patients whose food and hydration tubes are withdrawn:

Day One: Medical personnel use a simple surgical procedure to remove the percutaneous endoscopic gastrotomy tube, which is placed through the skin and into the stomach. Patients who do not have mental cognition to have a sense of thirst or hunger will not be uncomfortable.

Days Three to Four: Urine output decreases and patients begin to lose normal body secretions. The mouth begins to look dry and the eyes appear sunken. Patients will look thinner because the body tissues have lost fluid. Their heart rate gradually goes up, and their blood pressure goes down. In some patients, dehydration releases endorphins in the brain that create a state of euphoria.

Days Five to 10: People who are alert have a marked decrease in their alertness. Respiration becomes irregular with periods of very fast and then very slow breathing. Some patients will become restless, while others will be less active. For patients in a persistent vegetative state, there may be no discernible change in their movements.

Days 10 until Death: Patients do not appear to respond to their environment at all and may appear to be in a coma. The length of the death process is determined by how well-nourished patients were and how much body fat and fluid they had when the procedure began. There may be outward signs of dehydration, such as extremely dry skin. Kidney function declines, and toxins begin accumulating in the body. Toxins cause respiratory muscles to fail. Multiple organ systems begin to fail from lack of nutrition.

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