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Literature Review: Palliative Care in Intensive Care Units

Department of Anesthesia and Intensive Therapy, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University/RSUP Dr. Sardjito, Yogyakarta, Indonesia

Received: 19 Feb 2024; Revised: 13 Jul 2024; Accepted: 13 Sep 2024; Available online: 9 Sep 2024.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)
Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 International License.

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Abstract

Palliative care is defined as care with an approach that improves the quality of life of patients and their families in dealing with problems associated with life-threatening illnesses. As many as 75% of patients treated in the intensive care unit experience unpleasant symptoms. Various studies have shown that palliative care can reduce symptoms caused by invasive procedures in intensive care units and can provide end-of-life care. Thus, assisting patients proactively, decision-making with families, prospects for continued care planning and possible scenarios for end-of-life decisions are essential in intensive care units (ICUs). The integration of palliative care is an important part of comprehensive critical patient care. Critical care providers are often asked to provide pain relief to critically ill patients, hold family meetings to clarify the goals of care, deliver bad news, or provide end-of-life care and care for critically ill patients while providing support to their loved ones. Most ICU patients who are unable to make decisions rely on their families or carers for clinical decision making. Decision making for cardiopulmonary resuscitation, cessation of life-sustaining treatment (LST), and provision of artificial nutrition and hydration should be based on the patient's willingness to discontinue LST, with the involvement of family members and the multidisciplinary team, ensuring that decisions are aligned with the patient's values and goals. The application of palliative care in ICU care can relieve symptoms experienced by patients and can reduce unnecessary invasive procedures. In its application, decision making in palliative care must be based on ethical principles and involve the patient's family, and the decisions made must also be in line with the wishes and values of the patient. The application of palliative care focuses on good symptom management to reduce patient suffering.

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Keywords: critical illnes; ethical; intensive care unit; life sustaining treatment; palliative care; ventilation

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  1. Pan H, Shi W, Zhou Q, Chen G, Pan P. Palliative Care in the Intensive Care Unit: Not Just End-of-life Care. Intensive Care Research. 2022;3(1)
  2. Topçu S, Ecevit Alpar Ş, Gülseven B, Kebapçı A. Patient experiences in intensive care units: a systematic review. Patient Exp J. 2017;4(3)
  3. Khan M, Nishi SE. Intervention in family care tends to mitigate the stress-related symptoms of intensive care unit patient family members. Vol. 24, Evidence-Based Nursing. 2021
  4. George N, Bowman J, Aaronson E, Ouchi K. Past, present, and future of palliative care in emergency medicine in the USA. Acute Medicine & Surgery. 2020;7(1)
  5. Jennifer E. Reidy, Javier Barreda Garcia, Garbo Mak, Brandy McKelvy, Margaret Isaac, Suzana K. E. Makowski, et al. Irwin and Rippe’s Intensive Care Medicine. 8th ed. Vol. 8. Lippincott Williams & Wilkins; 2018. 296–335 p
  6. Mercadante S, Gregoretti C, Cortegiani A. Palliative care in intensive care units: Why, where, what, who, when, how. Vol. 18, BMC Anesthesiology. 2018
  7. Ryan K, Johnston B. Generalist and Specialist Palliative Care. In: Textbook of Palliative Care. 2019
  8. NHS England. Palliative and End of Life Care: Statutory Guidance for Integrated Care Boards (ICBs). Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2022
  9. Hasrima, Shafwan A, Wa Ode, Rahmadania, Indra, Narmawan, et al. Keperawatan Paliatif dan Menjelang Ajal. Vol. 5, Eureka Media Aksara. 2022
  10. Azzuri P, Azzuri P, Prasetyo H. Tindakan Euthanasia Pasif Oleh Dokter Terhadap Pasien Di Indonesia. JUSTITIA : Jurnal Ilmu Hukum dan Humaniora. 2021;8(4)
  11. Riani F. Kebijakan Nasional Dalam Perawatan Paliatif. Health N Hav. 2020;
  12. Kahveci K. Palliative care and intensive care integration. Medicine Science | International Medical Journal. 2017;
  13. Kyeremanteng K, Beckerleg W, Wan C, Vanderspank-Wright B, D’Egidio G, Sutherland S, et al. Survey on Barriers to Critical Care and Palliative Care Integration. American Journal of Hospice and Palliative Medicine. 2020;37(2)
  14. Rhoads S, Amass T. Communication at the End-of-Life in the Intensive Care Unit: A Review of Evidence-Based Best Practices. R I Med J (2013). 2019;102(10)
  15. Leone AF, King L, Liggett E, Aung A, Fonte G, Drinkwater SM, et al. Standardized proactive palliative care in the medical intensive care unit. J Palliat Med. 2018;21(5)
  16. McCarroll CM. Increasing Access to Palliative Care Services in the Intensive Care Unit. Dimensions of Critical Care Nursing. 2018;37(3)
  17. Clara MGS, Silva VR, Alves R, Coelho MC de R. The Palliative Care Screening Tool as an instrument for recommending palliative care for older adults. Revista Brasileira de Geriatria e Gerontologia. 2019;22(5)
  18. Bersten, Andrew D MBMF. Oh’s Intensive Care Manual, Eighth Edition. Vol. 8, Oh’s Intensive Care Manual, Eighth Edition. 2019
  19. Estella, Saralegui I, Rubio Sanchiz O, Hernández-Tejedor A, López Camps V, Martín MC, et al. Update and recommendations in decision making referred to limitation of advanced life support treatment. Med Intensiva. 2020;44(2)
  20. Robert R, Le Gouge A, Kentish-Barnes N, Adda M, Audibert J, Barbier F, et al. Sedation practice and discomfort during withdrawal of mechanical ventilation in critically ill patients at end-of-life: a post-hoc analysis of a multicenter study. Intensive Care Med. 2020;46(6)
  21. Coelho CBT, Yankaskas JR. New concepts in palliative care in the intensive care unit. Vol. 29, Revista Brasileira de Terapia Intensiva. 2017
  22. Fedele S, Strasser S, Roulin MJ. Validation of the Critical Care Pain Observational Tool in Palliative Care. Pain Management Nursing. 2020;21(4)
  23. Jennerich AL, Metaxa V, Rusinová K, Kesecioglu J. Palliative Care in Intensive Care Units. In: Lessons from the ICU. Springer Nature; 2023. p. 107–18
  24. Vincent F, Chapuis L, Zamparini E, Bornstain C. Palliative cares and the intensivist: not confined to the intensive care unit. Vol. 44, Intensive Care Medicine. 2018

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