From persistence to palliation: limiting active treatment in the ICU.

Abstract:

PURPOSE OF REVIEW:End-of-life care and communication deficits are important sources of conflicts within ICU teams and with patients or families. This narrative review describes recent studies on how to improve palliative care and surrogate decision-making in ICUs and compares the results with previously published literature on this topic. RECENT FINDINGS:Awareness and use of end-of-life recommendations is still low. Education about end-of-life is beneficial for end-of-life decisions. Residency and nurses training programmes start to integrate palliative care education in critical care. Integration of palliative care consults is recommended and probably cost-effective. Projects that promote direct contact of care team members with patients/families may be more likely to improve care than educational interventions for caregivers only. The family's response to critical illness includes adverse psychological outcome ('postintensive care syndrome-family'). Information brochures and structured communication protocols are likely to improve engagement of family members in surrogate decision-making; however, validation of outcome effects of their use is needed. SUMMARY:Optimizing palliative care and communication skills is the current challenge in ICU end-of-life care. Intervention strategies should be interdisciplinary, multiprofessional and family-centred in order to quickly reach these goals.

journal_name

Curr Opin Crit Care

authors

Wiedermann CJ,Lehner GF,Joannidis M

doi

10.1097/MCC.0b013e328358d417

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

693-9

issue

6

eissn

1070-5295

issn

1531-7072

journal_volume

18

pub_type

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