European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit.

Communication Conflict management Cultural variations Decision-making End of life Family-centered care GRADE Intensive care unit Palliative care

Journal

Intensive care medicine

ISSN: 1432-1238

Titre abrégé: Intensive Care Med

Pays: United States

ID NLM: 7704851

Informations de publication

Date de publication:
03 Oct 2024

Historique:

received: 04 07 2024

accepted: 28 07 2024

medline: 3 10 2024

pubmed: 3 10 2024

entrez: 3 10 2024

Statut: aheadofprint

Résumé

The European Society of Intensive Care Medicine (ESICM) has developed evidence-based recommendations and expert opinions about end-of-life (EoL) and palliative care for critically ill adults to optimize patient-centered care, improving outcomes of relatives, and supporting intensive care unit (ICU) staff in delivering compassionate and effective EoL and palliative care. An international multi-disciplinary panel of clinical experts, a methodologist, and representatives of patients and families examined key domains, including variability across countries, decision-making, palliative-care integration, communication, family-centered care, and conflict management. Eight evidence-based recommendations (6 of low level of evidence and 2 of high level of evidence) and 19 expert opinions were presented. EoL legislation and the importance of respecting the autonomy and preferences of patients were given close attention. Differences in EoL care depending on country income and healthcare provision were considered. Structured EoL decision-making strategies are recommended to improve outcomes of patients and relatives, as well as staff satisfaction and mental health. Early integration of palliative care and the use of standardized tools for symptom assessment are suggested for patients at high risk of dying. Communication training for ICU staff and printed communication aids for families are advocated to improve outcomes and satisfaction. Methods for enhancing family-centeredness of care include structured family conferences and culturally sensitive interventions. Conflict-management protocols and strategies to prevent burnout among healthcare professionals are also considered. The work done to develop these guidelines highlights many areas requiring further research.

Identifiants

DOI: 10.1007/s00134-024-07579-1 PMID: 39361081

pubmed: 39361081

doi: 10.1007/s00134-024-07579-1

pii: 10.1007/s00134-024-07579-1

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Références

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