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

被引：26

作者：

Kesecioglu, Jozef ^{[1
]}

Rusinova, Katerina ^{[2
,3
]}

Alampi, Daniela ^{[4
]}

Arabi, Yaseen M. ^{[5
,6
]}

Benbenishty, Julie ^{[7
]}

Benoit, Dominique ^{[8
,9
]}

Boulanger, Carole ^{[10
]}

Cecconi, Maurizio ^{[11
,12
]}

Cox, Christopher ^{[13
]}

van Dam, Marjel ^{[1
]}

van Dijk, Diederik ^{[1
]}

Downar, James ^{[14
,15
]}

Efstathiou, Nikolas ^{[16
]}

Endacott, Ruth ^{[17
]}

Galazzi, Alessandro ^{[18
]}

van Gelder, Fiona ^{[19
]}

Gerritsen, Rik T. ^{[20
]}

Girbes, Armand ^{[21
]}

Hawyrluck, Laura ^{[22
]}

Herridge, Margaret ^{[23
,24
]}

Hudec, Jan ^{[25
,26
,27
]}

Kentish-Barnes, Nancy ^{[28
]}

Kerckhoffs, Monika ^{[1
]}

Latour, Jos M. ^{[29
,30
,31
]}

Malaska, Jan ^{[26
,27
,32
,33
]}

Marra, Annachiara ^{[34
]}

Meddick-Dyson, Stephanie ^{[35
]}

Mentzelopoulos, Spyridon ^{[36
]}

Mer, Mervyn ^{[37
,38
,39
]}

Metaxa, Victoria ^{[40
,41
]}

Michalsen, Andrej ^{[42
]}

Mishra, Rajesh ^{[43
]}

Mistraletti, Giovanni ^{[44
,45
]}

van Mol, Margo ^{[46
]}

Moreno, Rui ^{[47
,48
,49
]}

Nelson, Judith ^{[50
]}

Suner, Andrea Ortiz ^{[51
,52
]}

Pattison, Natalie ^{[53
,54
]}

Prokopova, Tereza ^{[25
,26
,27
]}

Puntillo, Kathleen ^{[55
]}

Puxty, Kathryn ^{[56
,57
]}

Al Qahtani, Samah ^{[5
,6
]}

Radbruch, Lukas ^{[58
]}

Rodriguez-Ruiz, Emilio ^{[59
,60
,61
]}

Sabar, Ron ^{[62
]}

Schaller, Stefan J. ^{[63
,64
,65
]}

Siddiqui, Shahla ^{[66
]}

Sprung, Charles L. ^{[67
]}

Umbrello, Michele ^{[45
]}

Vergano, Marco ^{[68
]}

机构：

[1] Univ Utrecht, Univ Med Ctr Utrecht, Dept Intens Care Med, Utrecht, Netherlands

[2] Charles Univ Prague, Fac Med 1, Dept Palliat Med, Prague, Czech Republic

[3] Gen Univ Hosp Prague, Prague, Czech Republic

[4] Sapienza Univ Rome, AOU St Andrea, Rome, Italy

[5] King Saud Bin Abdulaziz Univ Hlth Sci, Intens Care Dept, Riyadh, Saudi Arabia

[6] King Abdullah Int Med Res Ctr, Minist Natl Guard Hlth Affairs, Riyadh, Saudi Arabia

[7] Hebrew Univ Jerusalem, Sch Nursing, Fac Med, Jerusalem, Israel

[8] Ghent Univ Hosp, Dept Intens Care Med, Ghent, Belgium

[9] Univ Ghent, Fac Med & Hlth Sci, Ghent, Belgium

[10] Royal Devon Univ NHS Fdn Trust, Exeter, England

[11] Humanitas Univ, Biomed Sci Dept, Milan, Italy

[12] IRCCS Humanitas Res Hosp, Dept Anaesthesia & Intens Care, Milan, Italy

[13] Duke Univ, Div Pulm & Crit Care Med, Durham, NC USA

[14] Univ Ottawa, Dept Med, Ottawa, ON, Canada

[15] Bruyere Res Inst, Ottawa, ON, Canada

[16] Univ Birmingham, Sch Nursing & Midwifery, Birmingham, England

[17] Natl Inst Hlth & Care Res, London, England

[18] Univ Udine, Dept Med, Udine, Italy

[19] Gelderse Vallei Hosp, Ede, Netherlands

[20] Med Ctr Leeuwarden, Ctr Intens Care, Leeuwarden, Netherlands

[21] AmsterdamUMC Locat VUmc, Dept Crit Care, Amsterdam, Netherlands

[22] Univ Toronto, Univ Hlth Network, Toronto Western Hosp, Interdept Div Crit Care Med, Toronto, ON, Canada

[23] Univ Hlth Network, Toronto Gen Res Inst, Crit Care & Resp Med, Toronto, ON, Canada

[24] Univ Toronto, Inst Med Sci, Interdept Div Crit Care Med, Toronto, ON, Canada

[25] Univ Hosp Brno, Dept Anaesthesiol & Intens Care Med, Brno, Czech Republic

[26] Masaryk Univ, Fac Med, Brno, Czech Republic

[27] Masaryk Univ, Dept Simulat Med, Fac Med, Brno, Czech Republic

[28] St Louis Hosp, APHP Nord, Famirea Res Grp, Intens Care Unit, Paris, France

[29] Univ Plymouth, Sch Nursing & Midwifery, Fac Hlth, Plymouth, England

[30] Curtin Univ, Curtin Sch Nursing, Perth, Australia

[31] Fudan Univ, Zhongshan Hosp, Dept Nursing, Shanghai, Peoples R China

[32] Univ Hosp Brno, Dept Paediat Anaesthesiol & Intens Care Med, Brno, Czech Republic

[33] Univ Hosp Brno, Dept Anaesthesiol & Intens Care Med 2, Brno, Czech Republic

[34] Univ Naples Federico II, Dept Neurosci Reprod Sci & Dent, Naples, Italy

[35] Univ Hull, Wolfson Palliat Care Res Ctr, Med Sch, Kingston Upon Hull, England

[36] Natl & Kapodistrian Univ Athens, Med Sch, Dept Intens Care Med 1, Evaggelismos Gen Hosp, Athens, Greece

[37] Charlotte Maxeke Johannesburg Acad Hosp CMJAH, Dept Med, Div Crit Care, Johannesburg, South Africa

[38] Charlotte Maxeke Johannesburg Acad Hosp CMJAH, Dept Med, Div Pulmonol, Johannesburg, South Africa

[39] Univ Witwatersrand, Fac Hlth Sci, Johannesburg, South Africa

[40] Kings Coll Hosp NHS Fdn Trust, Dept Crit Care, London, England

[41] Kings Coll London, London, England

[42] Konstanz Hosp, Dept Anesthesiol Crit Care Emergency Med & Pain T, Constance, Germany

[43] Ahmedabad Shaibya Comprehens Care Clin, Ahmadabad, India

[44] Univ Milan, Dept Pathophysiol & Transplantat, Milan, Italy

[45] Legnano Gen Hosp, ASST Ovest Milanese, SC Anesthesia & Intens Care, Milan, Italy

[46] Univ Med Ctr Rotterdam, Erasmus MC, Dept Intens Care Adults, Rotterdam, Netherlands

[47] Hosp Sao Jose, Unidade Local Saude Sao Jose, Lisbon, Portugal

[48] Ctr Clin Acad Lisboa, Fac Ciencias Med Lisboa, Nova Med Sch, Lisbon, Portugal

[49] Univ Beira Interior, Fac Ciencias Saude, Covilha, Portugal

[50] Weill Cornell Med Coll, Mem Hosp, New York, NY USA

来源：

INTENSIVE CARE MEDICINE | 2024年 / 50卷 / 11期

关键词：

Intensive care unit; End of life; GRADE; Cultural variations; Decision-making; Palliative care; Communication; Family-centered care; Conflict management; SHARED DECISION-MAKING; FAMILY-MEMBERS EXPERIENCES; CRITICALLY-ILL PATIENTS; BURNOUT SYNDROME; SUSTAINING TREATMENTS; SLEEP QUALITY; ICU PATIENTS; COMMUNICATION STRATEGY; LOVED ONE; PAIN;

D O I：

10.1007/s00134-024-07579-1

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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.

引用

页码：1740 / 1766

页数：27

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