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Palliative care in the ICU

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https://www.readbyqxmd.com/read/28099053/palliative-care-involvement-is-associated-with-less-intensive-end-of-life-care-in-adolescent-and-young-adult-oncology-patients
#1
Jennifer M Snaman, Erica C Kaye, Jessie J Lu, April Sykes, Justin N Baker
BACKGROUND: Adolescent and young adult oncology (AYAO) patients often receive intensive medical care and experience significant symptoms at the end of life (EOL). OBJECTIVE: This study aimed to describe the characteristics of AYAO patients aged 15-26 years who died as inpatients in a hospital and to compare the illness and EOL experiences of AYAO patients who did and did not receive palliative care (PC). DESIGN AND SETTING: A standardized data extraction tool was used to collect information about demographics, treatment, terminal characteristics, and symptoms during the last month of life (LMOL) for 69 AYAO patients who died while hospitalized between 2008 and 2014...
January 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28098632/palliative-care-in-the-icu-and-the-role-for-physician-assisted-dying-or-lack-thereof
#2
J Randall Curtis, Mark R Tonelli
No abstract text is available yet for this article.
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28060152/an-elevated-low-cardiac-output-syndrome-score-is-associated-with-morbidity-in-infants-after-congenital-heart-surgery
#3
Kalia P Ulate, Ofer Yanay, Howard Jeffries, Harris Baden, Jane L Di Gennaro, Jerry Zimmerman
OBJECTIVES: To evaluate an empirically derived Low Cardiac Output Syndrome Score as a clinical assessment tool for the presence and severity of Low Cardiac Output Syndrome and to examine its association with clinical outcomes in infants who underwent surgical repair or palliation of congenital heart defects. DESIGN: Prospective observational cohort study. SETTING: Cardiac ICU at Seattle Children's Hospital. PATIENTS: Infants undergoing surgical repair or palliation of congenital heart defects...
January 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28054288/post-traumatic-stress-disorder-and-complicated-grief-are-common-in-caregivers-of-neuro-icu-patients
#4
Stephen A Trevick, Aaron S Lord
BACKGROUND: To explore the effect of end of life and other palliative decision making scenarios on the mental health of family members of patients in the neuro-intensive care unit. METHODS: Decision makers of patients in the neuro-ICU at a large, urban, academic medical center meeting palliative care triggers were identified from November 10, 2014, to August 27, 2015. Interviews were conducted at 1 and 6 months post-enrollment. At 1 month, the Inventory of Complicated Grief-Revised (ICG-R), Impact of Events Scale-Revised (IES-R), and the Family Satisfaction-ICU (FS-ICU) were performed along with basic demographic questionnaires...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28042059/operationalizing-the-measuring-what-matters-spirituality-quality-metric-in-a-population-of-hospitalized-critically-ill-patients-and-their-family-members
#5
Rebecca A Aslakson, Josephine Kweku, Malonnie Kinnison, Sarabdeep Singh, Thomas Y Crowe
CONTEXT: Measuring What Matters (MWM) quality indicators support measurement of the percentage of patients who have spiritual discussions, if desired. OBJECTIVES: To 1) determine the ease of, and barriers to, prospectively collecting MWM spirituality quality measure data and 2) further explore the importance of spirituality in a seriously ill, hospitalized population of critically ill patients and their family members. METHODS: Electronic medical record (EMR) review and cross-sectional survey of ICU patients and their family members from October-December 2015...
December 29, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28011292/utilization-of-palliative-care-services-for-cardiac-arrest-patients-undergoing-therapeutic-hypothermia-a-retrospective-analysis
#6
Emily K Zern, Michael N Young, Taylor Triana, Meng Xu, Benjamin Holmes, Nyal Borges, John A McPherson, Mohana B Karlekar
BACKGROUND: Palliative care (PC) services are integral to the care of patients with advanced medical illnesses. Given the significant morbidity and mortality associated with cardiac arrest, we sought to measure the use and impact of PC in the care of patients treated with therapeutic hypothermia (TH). METHODS: We conducted a retrospective study of 317 consecutive patients undergoing TH after cardiac arrest. We compared intensive care unit (ICU) characteristics and clinical outcomes of subjects who received PC consultation (n=125) to those who did not (n=192)...
December 21, 2016: Resuscitation
https://www.readbyqxmd.com/read/28000489/medical-futility-treatment-in-intensive-care-units
#7
Marko Jukić, Lenko Šarić, Ivana Prkić, Livia Puljak
OBJECTIVE: To investigate cases of potential medical futility treatment in intensive care unit (ICU). MATERIALS AND METHODS: Retrospective review of 1567 charts of patients treated during the three-year period (2012 - 2014) in the ICU of the University Hospital Centre Split, Croatia, was conducted. More detailed analysis of the deceased patients' (n=429) charts was performed to identify cases of potential medical futility treatment. There were 99 patients for which ICU treatment was questionable due to their low Glasgow coma scale (GCS) score...
November 2016: Acta Medica Academica
https://www.readbyqxmd.com/read/27872409/complexity-analysis-of-decision-making-in-the-critically-ill
#8
Barbara J Daly, Sara L Douglas, Elizabeth O'Toole, James Rowbottom, Alan Hoffer, Amy R Lipson, Christopher Burant
RATIONALE: Despite multiple trials of interventions to improve end-of-life care of the critically ill, there is a persistent lack of understanding of factors associated with barriers to decision-making at the end of life. OBJECTIVE: To apply the principles of complexity science in examining the extent to which transitions to end-of-life care can be predicted by physician, family, or patient characteristics; outcome expectations; and the evaluation of treatment effectiveness...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27861180/improving-hospital-survival-and-reducing-brain-dysfunction-at-seven-california-community-hospitals-implementing-pad-guidelines-via-the-abcdef-bundle-in-6-064-patients
#9
Mary Ann Barnes-Daly, Gary Phillips, E Wesley Ely
OBJECTIVES: To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between ABCDEF bundle compliance and outcomes including hospital survival and delirium-free and coma-free days in community hospitals. DESIGN: A prospective cohort quality improvement initiative involving ICU patients...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27850037/397-a-survey-of-pediatric-critical-care-fellows-on-palliative-care-principles-applied-in-the-icu-setting
#10
Jaime Jump, Mindy Dickerman
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27843637/critically-ill-patients-with-cancer-chances-and-limitations-of-intensive-care-medicine-a-narrative-review
#11
REVIEW
Peter Schellongowski, Wolfgang R Sperr, Philipp Wohlfarth, Paul Knoebl, Werner Rabitsch, Herbert H Watzke, Thomas Staudinger
This narrative review deals with the challenge of defining adequate therapy goals and intensive care unit (ICU) admission criteria for critically ill patients with cancer. Several specific complications of critically ill patients with cancer require close collaborations of intensive care and cancer specialists. Intensivists require a basic understanding of the pathophysiology, diagnosis and therapy of common cancer-specific problems. Cancer specialists must be knowledgeable in preventing, detecting and treating imminent or manifest organ failures...
2016: ESMO Open
https://www.readbyqxmd.com/read/27813724/patterns-of-cost-for-patients-dying-in-the-intensive-care-unit-and-implications-for-cost-savings-of-palliative-care-interventions
#12
Nita Khandelwal, David Benkeser, Norma B Coe, Ruth A Engelberg, Joan M Teno, J Randall Curtis
BACKGROUND: Terminal intensive care unit (ICU) stays represent an important target to increase value of care. OBJECTIVE: To characterize patterns of daily costs of ICU care at the end of life and, based on these patterns, examine the role for palliative care interventions in enhancing value. DESIGN: Secondary analysis of an intervention study to improve quality of care for critically ill patients. SETTING/PATIENTS: 572 patients who died in the ICU between 2003 and 2005 at a Level-1 trauma center...
November 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27789776/chemotherapy-near-the-end-of-life-for-chinese-patients-with-solid-malignancies
#13
Jin Sheng, Ya-Xiong Zhang, Xiao-Bo He, Wen-Feng Fang, Yun-Peng Yang, Gui-Nan Lin, Xuan Wu, Ning Li, Jing Zhang, Lin-Zhu Zhai, Yuan-Yuan Zhao, Yan Huang, Ning-Ning Zhou, Hong-Yun Zhao, Li Zhang
INTRODUCTION: There are increasing concerns about the negative impacts of chemotherapy near the end of life (EOL). There is discrepancy among different countries about its use, and little is known about the real-world situation in China. PATIENTS AND METHODS: This retrospective study was conducted at six representative hospitals across China. Adult decedents with a record of advanced solid cancer and palliative chemotherapy were consecutively screened from 2010 through 2014...
October 27, 2016: Oncologist
https://www.readbyqxmd.com/read/27768613/a-randomized-trial-of-palliative-care-discussions-linked-to-an-automated-early-warning-system-alert
#14
David Picker, Maria Dans, Kevin Heard, Thomas Bailey, Yixin Chen, Chenyang Lu, Marin H Kollef
OBJECTIVE: To determine whether an Early Warning System could identify patients wishing to focus on palliative care measures. DESIGN: Prospective, randomized, pilot study. SETTING: Barnes-Jewish Hospital, Saint Louis, MO (January 15, 2015, to December 12, 2015). PATIENTS: A total of 206 patients; 89 intervention (43.2%) and 117 controls (56.8%). INTERVENTIONS: Palliative care in high-risk patients targeted by an Early Warning System...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27763820/is-there-hope-is-she-there-how-families-and-clinicians-experience-severe-acute-brain-injury
#15
Rachael E C Schutz, Heather L Coats, Ruth A Engelberg, J Randall Curtis, Claire J Creutzfeldt
BACKGROUND: Patients with severe acute brain injury (SABI) raise important palliative care considerations associated with sudden devastating injury and uncertain prognosis. OBJECTIVE: The goal of this study was to explore how family members, nurses, and physicians experience the palliative and supportive care needs of patients with SABI receiving care in the neuroscience intensive care unit (neuro-ICU). DESIGN: Semistructured interviews were audiotaped, transcribed, and analyzed using thematic analysis...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27754815/referral-to-palliative-care-infrequent-in-patients-with-idiopathic-pulmonary-fibrosis-admitted-to-an-intensive-care-unit
#16
Zhan Liang, Leslie A Hoffman, Mehdi Nouraie, Daniel J Kass, Michael P Donahoe, Kevin F Gibson, Melissa I Saul, Kathleen O Lindell
BACKGROUND: Palliative care has been recommended as a means to assist patients with idiopathic pulmonary fibrosis (IPF) in managing symptom burden and advanced care planning. Timing of referral is important because although most patients display a gradually progressive course, a minority experience acute deterioration, an outcome associated with high mortality. AIM: To describe characteristics of IPF patients referred to a specialty lung disease center over a 10-year period who experienced acute deterioration and subsequent intensive care unit (ICU) admission, including frequency and timing of referral to palliative care...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27738795/the-role-of-palliative-care-in-the-last-month-of-life-in-elderly-cancer-patients
#17
Tarek Assi, Elie El Rassy, Tony Ibrahim, Tania Moussa, Aline Tohme, Fadi El Karak, Fadi Farhat, Salma Faddoul, Marwan Ghosn, Joseph Kattan
INTRODUCTION: One major health care issue encountered in elderly cancer patients is the alteration of the quality of life. The purpose of our study is to evaluate the administration of chemotherapy in the last month of life (CLML) and to evaluate the impact of the palliative care consult (PCC) in the elderly patients. METHODS: We conducted a retrospective observational study that included elderly patients diagnosed with an end-stage cancer and who were deceased between the 1st of January 2012 and the 31st of December 2015...
February 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27722910/niv-by-an-interdisciplinary-respiratory-care-team-in-severe-respiratory-failure-in-the-emergency-department-limited-to-day-time-hours
#18
Christian Michael Horvath, Martin Horvath Brutsche, Otto Dagobert Schoch, Bernarde Schillig, Florent Baty, Dieter vonOw, Jochen Julius Rüdiger
Non-invasive ventilatory support is frequently used in patients with severe respiratory failure (SRF), but is often limited to intensive care units (ICU). We hypothesized that an instantaneous short course of NIV (up to 2 h), limited to regular working hours as an additional therapy on the emergency department (ED) would be feasible and could improve patient´s dyspnoea measured by respiratory rate and Borg visual dyspnea scale. NIV was set up by an interdisciplinary respiratory care team. Outside these predefined hours NIV was performed in the ICU...
October 8, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27720791/impact-of-palliative-care-screening-and-consultation-in-the-icu-a-multihospital-quality-improvement-project
#19
Robert J Zalenski, Spencer S Jones, Cheryl Courage, Denise R Waselewsky, Anna S Kostaroff, David Kaufman, Afzal Beemath, John Brofman, James W Castillo, Hicham Krayem, Anthony Marinelli, Bradley Milner, Maria Teresa Palleschi, Mona Tareen, Sheri Testani, Ayman Soubani, Julie Walch, Judy Wheeler, Sonali Wilborn, Hanna Granovsky, Robert D Welch
CONTEXT: There are few multicenter studies that examine the impact of systematic screening for palliative care and specialty consultation in the intensive care unit (ICU). OBJECTIVE: To determine the outcomes of receiving palliative care consultation (PCC) for patients who screened positive on palliative care referral criteria. METHODS: In a prospective quality assurance intervention with a retrospective analysis, the covariate balancing propensity score method was used to estimate the conditional probability of receiving a PCC and to balance important covariates...
January 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27717509/patterns-of-palliative-care-service-consultation-in-a-sample-of-critically-ill-icu-patients-at-high-risk-of-dying
#20
Jennifer B Seaman, Amber E Barnato, Susan M Sereika, Mary Beth Happ, Judith A Erlen
OBJECTIVE: Describe patterns of palliative care service consultation among a sample of ICU patients at high risk of dying. BACKGROUND: Patients receiving mechanical ventilation (MV) face threats to comfort, social connectedness and dignity due to pain, heavy sedation and physical restraint. Palliative care consultation services may mitigate poor outcomes. METHODS: From a dataset of 1440 ICU patients with ≥2 days of MV and ≥12 h of sustained wakefulness, we identified those at high risk of dying and/or who died and assessed patterns of sub-specialty palliative care consultation...
January 2017: Heart & Lung: the Journal of Critical Care
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