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姑息治疗对补充左心室辅助装置患者管理的作用

Usefulness of Palliative Care to Complement the Management of Patients on Left Ventricular Assist Devices.

作者信息

Luo Nancy, Rogers Joseph G, Dodson Gwen C, Patel Chetan B, Galanos Anthony N, Milano Carmelo A, O'Connor Christopher M, Mentz Robert J

机构信息

Division of Cardiology, Department of Internal Medicine, Duke University Medical Center, Durham, North Carolina.

Division of Cardiology, Department of Internal Medicine, Duke University Medical Center, Durham, North Carolina.

出版信息

Am J Cardiol. 2016 Sep 1;118(5):733-8. doi: 10.1016/j.amjcard.2016.06.010. Epub 2016 Jun 21.

Abstract

Within the last decade, advancements in left ventricular assist device therapy have allowed patients with end-stage heart failure (HF) to live longer and with better quality of life. Like other life-saving interventions, however, there remains the risk of complications including infections, bleeding episodes, and stroke. The candidate for left ventricular assist device therapy faces complex challenges going forward, both physical and psychological, many of which may benefit from the application of palliative care principles by trained specialists. Despite these advantages, palliative care remains underused in many advanced HF programs. Here, we describe the benefits of palliative care, barriers to use within HF, and specific applications to the integrated care of patients on mechanical circulatory support.

摘要

在过去十年中,左心室辅助装置治疗取得了进展,使终末期心力衰竭(HF)患者能够活得更长,生活质量更高。然而,与其他挽救生命的干预措施一样,仍然存在并发症风险,包括感染、出血事件和中风。左心室辅助装置治疗的候选人在未来面临着复杂的身体和心理挑战,其中许多挑战可能受益于受过培训的专家应用姑息治疗原则。尽管有这些优势,但姑息治疗在许多晚期心力衰竭项目中仍未得到充分利用。在此,我们描述了姑息治疗的益处、心力衰竭治疗中使用姑息治疗的障碍,以及在机械循环支持患者综合护理中的具体应用。

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本文引用的文献

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The palliative care in heart failure trial: rationale and design.心力衰竭姑息治疗试验:原理和设计。
Am Heart J. 2014 Nov;168(5):645-651.e1. doi: 10.1016/j.ahj.2014.07.018. Epub 2014 Jul 30.
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Ten common questions (and their answers) on medical futility.关于医疗无效性的十个常见问题(及其答案)。
Mayo Clin Proc. 2014 Jul;89(7):943-59. doi: 10.1016/j.mayocp.2014.02.005. Epub 2014 Apr 13.
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Left ventricular assist device withdrawal: an ethical discussion.左心室辅助装置撤离:一场伦理讨论
BMJ Support Palliat Care. 2014 Jun;4(2):193-195. doi: 10.1136/bmjspcare-2012-000347. Epub 2013 Jan 7.
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Deactivation of a left ventricular assist device at the end of life #269.临终时停用左心室辅助装置#269
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