Palliative Care in the Trauma and Surgical Critical Care Settings: A Narrative Review

被引:5
作者
Newsome, Kevin [1 ]
Sauder, Matthew [2 ]
Spardy, Jeffrey [1 ]
Kodadek, Lisa [3 ]
Ang, Darwin [4 ]
Michetti, Christopher P. [5 ]
Bilski, Tracy [6 ,7 ]
Elkbuli, Adel [6 ,7 ]
机构
[1] Florida Int Univ, Herbert Wertheim Coll Med, Miami, FL 33199 USA
[2] NSU NOVA Southeastern Univ, Dr Kiran C Patel Coll Allopath Med, Ft Lauderdale, FL USA
[3] Yale Sch Med, Dept Surg, New Haven, CT USA
[4] Ocala Reg Med Ctr, Dept Surg, Div Trauma & Surg Crit Care, Ocala, FL USA
[5] Nova Fairfax Hosp, Nova Trauma Ctr, Dept Surg, INOVA, Fairfax, VA USA
[6] Orlando Reg Med Ctr Inc, Dept Surg, Div Trauma & Surg Crit Care, 52 W Underwood St, Orlando, FL 32806 USA
[7] Orlando Reg Med Ctr Inc, Dept Surg Educ, Orlando, FL 32806 USA
关键词
palliative care; goals of care; surgical critical care; trauma surgery; improved outcomes; OF-LIFE CARE; MEDICINE CONSULTATION; COMMUNICATION; UNIT; RECOMMENDATIONS; EDUCATION; SURGEONS; ACCESS;
D O I
10.1177/00031348221101597
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background We aimed to conduct a narrative review of available literature to understand the use of palliative care in the trauma and surgical critical care setting. Methods PubMed, EMBASE, and Google Scholar databases were searched for studies investigating the use of palliative care in the trauma and surgical critical care setting. The search included all studies published through January 9th, 2022. The risk of bias of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist tools. Outcomes were summarized in tables and synthesized qualitatively. Results A total of 22 studies were included in this review. Key elements of successful palliative care include communication, shared decision-making, family involvement, pain control, establishing a patient's prognosis, and end-of-life management. Approaches to implementation based upon these key elements include best-case/worst-case scenarios, consultation trigger systems, and integrated institutional palliative care programs. Palliative care may reduce hospital length of stay, improve symptom management, and increase patient satisfaction, but the impact on mortality is unclear. Conclusion The core elements of palliative care have been identified and palliative care has been shown to improve outcomes in trauma and surgical critical care. However, the approaches for implementation still require development. The underutilization of palliative care for trauma patients reveals the need for refining criteria for use of palliative care and improvement in the education of surgical critical care teams to provide primary palliative care services.
引用
收藏
页码:1355 / 1364
页数:10
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