<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1886-5887</journal-id>
<journal-title><![CDATA[Revista de Bioética y Derecho]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Bioética y Derecho]]></abbrev-journal-title>
<issn>1886-5887</issn>
<publisher>
<publisher-name><![CDATA[Observatori de Bioètica i Dret - Cátedra UNESCO de Bioética]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1886-58872020000100006</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Limitación de soporte vital. Cuidados paliativos y final de vida en UCI]]></article-title>
<article-title xml:lang="en"><![CDATA[Limitation of life support. Palliative care and end of life in ICU]]></article-title>
<article-title xml:lang="ca"><![CDATA[Limitació de suport vital. Cures pal·liatives i final de vida a l' UCI]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rubio Sanchiz]]></surname>
<given-names><![CDATA[Olga]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ventura Pascual]]></surname>
<given-names><![CDATA[Lara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Sant Joan de Déu Servicio Medicina Intensiva ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Althaia Xarxa Hospitalaria Universitaria de Manresa  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2020</year>
</pub-date>
<numero>48</numero>
<fpage>81</fpage>
<lpage>93</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1886-58872020000100006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1886-58872020000100006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1886-58872020000100006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La misión de los cuidados intensivos es restaurar la situación basal de salud libre de discapacidad severa atendiendo al principio bioético de beneficencia, respetando la dignidad y voluntad del paciente de ser tratado lo que vendría a ser atender al principio bioético de autonomía, y realizando todo esto de una forma adecuada a la mejor evidencia actual, justa y sostenible atendiendo a los principios de no maleficencia y de justicia. Cuando no es posible es cuando los profesionales tienen la obligación ética de iniciar un diálogo de manera respetuosa y prudente con el paciente y/o la familia y el resto de profesionales implicados (atención primaria, enfermería, especialistas...etc.) de cara a llegar a un consenso sobre limitar los tratamientos de soporte vital y/o adecuar los cuidados y continuar el tratamiento con un plan terapéutico de cuidados dirigidos al confort, control de síntomas y a mejorar la calidad de vida (Plan de cuidados paliativos) para preservar la dignidad del paciente, evitar el sufrimiento y proporcionar un tratamiento compasivo de soporte y acompañamiento durante el proceso de muerte si se diera el mismo atendiendo al paciente y a la familia con el máximo cuidado y respeto en un marco de humanización de la salud. Atender de forma excelente el final de la vida significa dignificar a las personas que están pasando por ese proceso, aportar un valor extraordinario de humanidad y debe ser un objetivo prioritario actual en nuestro quehacer diario en las unidades de cuidados intensivos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract The mission of intensive care is to restore the baseline health situation free of severe disability by following the bioethical principle of beneficence, respecting the dignity and willingness of the patient to be treated what would be to attend to the bioethical principle of autonomy, and doing all this in a manner appropriate to the best current, fair and sustainable evidence, taking into account the principles of non-maleficence and justice. When it is not possible, it is when professionals have the ethical obligation to initiate a dialogue in a respectful and prudent manner with the patient and / or the family and the rest of the professionals involved (primary care, nursing, specialists ... etc.) Face to reach a consensus on limiting life support treatments and / or adapt care and continue treatment with a therapeutic plan of care aimed at comfort, symptom control and improving the quality of life (Palliative Care Plan) to preserve the dignity of the patient, avoid suffering and provide a compassionate support and support during the death process if the same were given to the patient and the family with the utmost care and respect in a framework of humanization of health. Addressing the end of life in an excellent way means dignifying the people who are going through this process, providing an extraordinary value of humanity and must be a current priority in our daily work in the intensive care units.]]></p></abstract>
<abstract abstract-type="short" xml:lang="ca"><p><![CDATA[Resum La finalitat de la vigilància intensiva és restaurar la situació basal de salut lliure de discapacitat severa atenent al principi bioètic de beneficència, respectant la dignitat i voluntat del pacient de ser tractat, cosa que vindria a ser atendre al principi bioètic d'autonomia, i realitzant tot això d'una forma adequada a la millor evidència actual, justa i sostenible, atesos els principis de no maleficència i de justícia. Quan tot això no és possible és quan els professionals tenen l'obligació ètica d'iniciar un diàleg de manera respectuosa i prudent amb el pacient i/o la família i amb la resta de professionals implicats (atenció primària, infermeria, especialistes...etc.) de cara a arribar a un consens sobre limitar els tractaments de suport vital i/o adequar les cures i continuar el tractament amb un pla terapèutic de cures dirigides al confort, el control de símptomes i a millorar la qualitat de vida (Pla de Cures Pal·liatives) per a preservar la dignitat del pacient, evitar el sofriment i proporcionar-li un tractament compassiu de suport i acompanyament durant el procés de mort, atenent el pacient i a la família amb la màxima cura i respecte en un marc d'humanització de la salut. Atendre de forma excel·lent el final de la vida significa dignificar les persones que estan passant per aquest procés, aportar un valor extraordinari d'humanitat i ha de ser un objectiu prioritari actual en el nostre quefer diari en les unitats de vigilància intensiva.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Final de vida]]></kwd>
<kwd lng="es"><![CDATA[limitación de tratamientos]]></kwd>
<kwd lng="es"><![CDATA[cuidados paliativos]]></kwd>
<kwd lng="es"><![CDATA[duelo]]></kwd>
<kwd lng="en"><![CDATA[End of life]]></kwd>
<kwd lng="en"><![CDATA[limitation of treatments]]></kwd>
<kwd lng="en"><![CDATA[palliative care]]></kwd>
<kwd lng="en"><![CDATA[grief]]></kwd>
<kwd lng="ca"><![CDATA[Final de vida]]></kwd>
<kwd lng="ca"><![CDATA[limitació de tractaments]]></kwd>
<kwd lng="ca"><![CDATA[cures pal·liatives]]></kwd>
<kwd lng="ca"><![CDATA[dol]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Recommendations for end-of-life care in the intensive care unit: The Ethics Committee of the Society of Critical Care Medicine]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Truog]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cist]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Brackett]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Burns]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Curley]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Danis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Crit Care Med]]></source>
<year>2001</year>
<volume>29</volume>
<page-range>2332-48</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Recomendaciones de tratamiento al final de la vida del paciente crítico]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Monzón]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Saralegui]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Abizanda]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cabré]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Iribarren]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Martín]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
</person-group>
<source><![CDATA[Med Intensiva]]></source>
<year>2008</year>
<volume>32</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>121-33</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Patients and families preferences for medical intensive care]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Danis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Patrick]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Southerland]]></surname>
<given-names><![CDATA[LI]]></given-names>
</name>
<name>
<surname><![CDATA[Green]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<source><![CDATA[JAMA]]></source>
<year>1988</year>
<volume>260</volume>
<page-range>797-802</page-range></nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[End-of-life Decision Making in The Intensive Care Unit University of California San Francisco, and San Francisco General Hospital, San Francisco California. Concise Clinical Review]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Luce]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2010</year>
<volume>182</volume>
<page-range>6-11</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[End-of-life. Decision Making in The Intensive Care Unit University of California San Francisco, and San Francisco General Hospital, San Francisco California. Concise Clinical Review]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Luce]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2010</year>
<volume>182</volume>
<page-range>6-11</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[La enfermera frente a la limitación del tratamiento de soporte vital en las Unidades de Cuidados Intensivos Aspectos técnicos y prácticos a considerar]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Falco]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Enferm Intensiva]]></source>
<year>2009</year>
<volume>20</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>104-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[End-of-life. Decision Making in The Intensive Care Unit University of California San Francisco, and San Francisco General Hospital, San Francisco California. Concise Clinical Review]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Luce]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2010</year>
<volume>182</volume>
<page-range>6-11</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="">
<collab>Hastings Center</collab>
<source><![CDATA[Guidelines on the termination of treatment and the care of the dying]]></source>
<year>1987</year>
<publisher-loc><![CDATA[Briarcliff Manor, NY ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Withholding and withdrawald of life support in intensive-care units in France: A prospective survey. French LATEREA Group]]></article-title>
<collab>Ferrand LATEREA Group</collab>
<source><![CDATA[Lancet]]></source>
<year>2001</year>
<page-range>357-14</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Limitación del tratamiento de soporte vital en pacientes con ingreso prolongado en UCI. Situación actual en España a la vista del Estudio EPIPUSE]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hernández]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Med intensiva]]></source>
<year>2015</year>
<volume>39</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>395-404</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Global variability in withholding and withdrawal of life-sustaining treatment in the intensive care unit: a systematic review]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mark]]></surname>
<given-names><![CDATA[NM]]></given-names>
</name>
<name>
<surname><![CDATA[Rayner]]></surname>
<given-names><![CDATA[SG]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
<name>
<surname><![CDATA[Curtis]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
</person-group>
<source><![CDATA[Intensive Care Med]]></source>
<year>2015</year>
<volume>41</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1572-85</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The Durban World Congress Ethics round Table Conference report: II. Withholding or withdrawing of treatment in elderly patients admitted to the intensive Care Unit]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guidet]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Hodgson]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Feldman]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Paruk]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Lipman]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Koh]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Vincent]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Azoulay]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Sprung]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[J Crit Care]]></source>
<year>2014</year>
<volume>29</volume>
<page-range>896-901</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Older age, agressiveness of care, and survival for seriously ill, hospitalitzated adults. Support Investigadors. Study to understand prognoses and preferences for outcomes and risks if treatments]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hamel]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
<name>
<surname><![CDATA[Davis]]></surname>
<given-names><![CDATA[RB]]></given-names>
</name>
<name>
<surname><![CDATA[Teno]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<source><![CDATA[Ann Intern Med]]></source>
<year>1999</year>
<volume>131</volume>
<page-range>721-8</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Treatment limitations at admission to intensive care units in Australia and New Zealand: prevalence, outcomes, and resource use]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Godfrey]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Crit Care Med]]></source>
<year>2012</year>
<volume>40</volume>
<page-range>2082-9</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Limitation of life support tecniques at admission to the intensive care unit: a multicenter prospective cohort study]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rubio]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
</person-group>
<source><![CDATA[J Intensive Care]]></source>
<year>2018</year>
<volume>6</volume>
<page-range>24</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The ICU Trial a new admission policy for cáncer patients requiring mechanical ventilation]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lecouyer]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Chevret]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Thiery]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Darmom]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Schlemmer]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Azoulay]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<source><![CDATA[Crit Care Med]]></source>
<year>2007</year>
<volume>35</volume>
<page-range>808-14</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Multicenter study of the multiple organ dysfunction syndrome in intensive care units: the usefulness of Sequential Organ Failure Assessment scores in decision making]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cabre]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Intensive Care Med]]></source>
<year>2005</year>
<volume>31</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>927-33</page-range></nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tejedor]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Herranz]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Nicolás]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[García]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Recomendaciones sobre toma de decisiones y cuidados al final de la vida en neonatología]]></article-title>
<collab>Grupo de Trabajo de Ética de la Sociedad Española de Neonatología</collab>
<source><![CDATA[An Pediatr (Barc)]]></source>
<year>2013</year>
<volume>78</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>190.e1-190.e14</page-range></nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[End-of-life. Decision Making in The Intensive Care Unit University of California San Francisco, and San Francisco General Hospital, San Francisco California. Concise Clinical Review]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Luce]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2010</year>
<volume>182</volume>
<page-range>6-11</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[An Intensive communication intervention for the critical ill]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lilly]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[DeMeo]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
<name>
<surname><![CDATA[Sona]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Haley]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
<name>
<surname><![CDATA[Massaro]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Wallace]]></surname>
<given-names><![CDATA[RF]]></given-names>
</name>
</person-group>
<source><![CDATA[Am J Med]]></source>
<year>2000</year>
<volume>109</volume>
<page-range>469-4</page-range></nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Comfort Care for Patients Dying in the Hospital]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Craig]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Blinderman]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Andrew Billings]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<source><![CDATA[N Engl J Med]]></source>
<year>2015</year>
<volume>373</volume>
<page-range>2549-256</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
