Palliative Care in Congestive Heart Failure

被引:234
作者
Goodlin, Sarah J. [1 ]
机构
[1] Patient Centered Educ & Res, Salt Lake City, UT 84103 USA
关键词
end of life; palliative care; symptom management; heart failure; QUALITY-OF-LIFE; POSITIVE AIRWAY PRESSURE; EXERCISE CAPACITY; ELDERLY-PATIENTS; CONTROLLED-TRIAL; EJECTION FRACTION; CLINICAL-TRIALS; HEALTH-STATUS; DOUBLE-BLIND; SLEEP-APNEA;
D O I
10.1016/j.jacc.2009.02.078
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Symptoms and compromised quality of life prevail throughout the course of heart failure (HF) and thus should be specifically addressed with palliative measures. Palliative care for HF should be integrated into comprehensive HF care, just as evidence-based HF care should be included in end-of-life care for HF patients. The neurohormonal and catabolic derangements in HF are at the base of HF symptoms. A complex set of abnormalities can be addressed with a variety of interventions, including evidence-based HF care, specific exercise, opioids, treatment of sleep-disordered breathing, and interventions to address patient and family perceptions of control over their illness. Both potential sudden cardiac death and generally shortened length of life by HF should be acknowledged and planned for. Strategies to negotiate communication about prognosis with HF patients and their families can be integrated into care. Additional evidence is needed to direct care at the end of life, including use of HF medications, and to define management of multiple sources of distress for HF patients and their families. (J Am Coll Cardiol 2009; 54: 386-96) (C) 2009 by the American College of Cardiology Foundation
引用
收藏
页码:386 / 396
页数:11
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