Publicação

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

Detalhes bibliográficos
Resumo:	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.
Autores principais:	Kesecioglu, Jozef
Outros Autores:	Rusinova, Katerina; Alampi, Daniela; Arabi, Yaseen M.; Benbenishty, Julie; Benoit, Dominique; Boulanger, Carole; Cecconi, Maurizio; Cox, Christopher; van Dam, Marjel; van Dijk, Diederik; Downar, James; Efstathiou, Nikolas; Endacott, Ruth; Galazzi, Alessandro; van Gelder, Fiona; Gerritsen, Rik T.; Girbes, Armand; Hawyrluck, Laura; Herridge, Margaret; Hudec, Jan; Kentish-Barnes, Nancy; Kerckhoffs, Monika; Latour, Jos M.; Malaska, Jan; Marra, Annachiara; Meddick-Dyson, Stephanie; Mentzelopoulos, Spyridon; Mer, Mervyn; Metaxa, Victoria; Michalsen, Andrej; Mishra, Rajesh; Mistraletti, Giovanni; van Mol, Margo; Moreno, Rui; Nelson, Judith; Suñer, Andrea Ortiz; Pattison, Natalie; Prokopova, Tereza; Puntillo, Kathleen; Puxty, Kathryn; Qahtani, Samah Al; Radbruch, Lukas; Rodriguez-Ruiz, Emilio; Sabar, Ron; Schaller, Stefan J.; Siddiqui, Shahla; Sprung, Charles L.; Umbrello, Michele; Vergano, Marco; Zambon, Massimo; Zegers, Marieke; Darmon, Michael; Azoulay, Elie
Assunto:	Communication Conflict management Cultural variations Decision-making End of life Family-centered care GRADE Intensive care unit Palliative care Critical Care and Intensive Care Medicine SDG 3 - Good Health and Well-being
Ano:	2024
País:	Portugal
Tipo de documento:	artigo
Tipo de acesso:	acesso aberto
Instituição associada:	Universidade Nova de Lisboa
Idioma:	inglês
Origem:	Repositório Institucional da UNL

Descrição
Resumo:	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.