European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit
Year: 2024
Type: article
Abstract: 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.
Source: Intensive Care Medicine
Authors: Jozef Kesecioglu, Katerina Rusinova, Daniela Alampi, Yaseen M. Arabi, Julie Benbenishty, Dominique Benoit, Carole Boulanger, Maurizio Cecconi, Christopher Cox, Marjel van Dam, Diederik van Dijk, James Downar, Nikolas Efstathiou, Ruth Endacott, Alessandro Galazzi, Fiona van Gelder, Rik T. Gerritsen, Armand Girbes, Laura Hawyrluck, Margaret Herridge, Jan Hudec, Nancy Kentish-Barnes, Monika Kerckhoffs, Jos M. Latour, Jan Malaska, Annachiara Marra, Stephanie Meddick-Dyson, Spyridon Mentzelopoulos, Mervyn Mer, Victoria Metaxa, Andrej Michalsen, Rajesh Mishra, Giovanni Mistraletti, Margo van Mol, Rui Moreno, Judith Nelson, Andrea Ortiz Suñer, Natalie Pattison, Tereza Prokopova, Kathleen Puntillo, Kathryn Puxty, Samah Al Qahtani, Lukas Radbruch, Emilio Rodriguez-Ruiz, Ron Sabar, Stefan J. Schaller, Shahla Siddiqui, Charles L. Sprung, Michele Umbrello, Marco Vergano, Massimo Zambon, Marieke Zegers, Michael Darmon, Elie Azoulay
Institutions: Utrecht University, University Medical Center Utrecht, Charles University, General University Hospital in Prague, Sapienza University of Rome, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, National Guard Health Affairs, Hebrew University of Jerusalem, Ghent University Hospital, Ghent University, Royal Devon University Healthcare NHS Foundation Trust, Humanitas University, IRCCS Humanitas Research Hospital, Duke University, University of Ottawa, Bruyère, University of Birmingham, National Institute for Health and Care Research, University of Udine, Ziekenhuis Gelderse Vallei, Medisch Centrum Leeuwarden, Amsterdam UMC Location Vrije Universiteit Amsterdam, University Health Network, University of Toronto, Toronto Western Hospital, Masaryk University, University Hospital Brno, Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Louis, Curtin University, Fudan University, Zhongshan Hospital, University of Plymouth, University of Naples Federico II, University of Hull, Hull York Medical School, National and Kapodistrian University of Athens, Evangelismos Hospital, University of the Witwatersrand, Johannesburg Hospital, King's College London, King's College Hospital NHS Foundation Trust, King's College Hospital, Klinikum Konstanz, University of Milan, Aziende Socio Sanitarie Territoriale Ovest Milanese, Erasmus MC, University of Beira Interior, Unidade Local de Saúde de São José, Hospital de São José, Universidade Nova de Lisboa, Cornell University, Weill Cornell Medicine, Valencia Catholic University Saint Vincent Martyr, Hospital Arnau de Vilanova, University of Hertfordshire, Imperial College Healthcare NHS Trust, East and North Hertfordshire NHS Trust, Imperial College London, University of California, San Francisco, Glasgow Royal Infirmary, University of Glasgow, University of Bonn, University Hospital Bonn, Universidade de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago, Servicio Gallego de Salud, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Beth Israel Deaconess Medical Center, Harvard University, Hadassah Medical Center, Ospedale San Giovanni Bosco, Radboud University Medical Center, Université Paris Cité
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,990
Funders: Pfizer, Bayer, Sanofi, Gilead Sciences, Alexion Pharmaceuticals, University of Washington, University of Pittsburgh, Società Italiana Anestesia, Analgesia, Rianimazione e Terapia Intensiva, National Institute for Health and Care Research, Agence Nationale de la Recherche, Università degli Studi di Milano-Bicocca, Siemens, Masarykova Univerzita, Lékařská fakulta, Masarykova univerzita, European Society of Intensive Care Medicine, Gemeinsame Bundesausschuss, National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Nursing Research, European Health and Digital Executive Agency
OpenAlex ID: W4403083369