Department of Critical Care Medicine, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Box # 0112, Houston, TX 77030, USA.
Crit Care Clin. 2010 Jan;26(1):219-27. doi: 10.1016/j.ccc.2009.10.002.
This article discusses end-of-life issues in critically ill cancer patients. Since the majority of deaths will occur after limiting or withdrawing life support, focus should be given to ensuring that multidisciplinary family meetings are convened to discuss end-of-life decision making. Throughout the process of transitioning from cure to comfort care, it is essential to support the patient and the patient's family cultural beliefs and spiritual values, and to ensure good pain and symptom management. The use of protocols facilitates a smooth transition and potentially reduces variability between health care providers. Integrating measures into the ICU routine that will help health care providers cope with the care of a dying patient is recommended to avoid moral distress or emotional burnout.
本文讨论了危重症癌症患者的临终问题。由于大多数死亡将发生在限制或撤回生命支持之后，因此应重点确保召开多学科家庭会议，讨论临终决策。在从治愈转向舒适护理的过程中，必须支持患者及其家属的文化信仰和精神价值观，并确保良好的疼痛和症状管理。使用协议可促进平稳过渡，并可能减少医疗保健提供者之间的差异。建议将措施整合到 ICU 常规中，以帮助医疗保健提供者应对临终患者的护理，从而避免道德困境或情绪疲惫。
