Mercadante Sebastiano, Gregoretti Cesare, Cortegiani Andrea
Anesthesia and Intensive Care Unit and Pain Relief and Supportive-Palliative Care Unit, La Maddalena Cancer Center, Via san Lorenzo 312, 90145, Palermo, Italy.
Department of Biopathology and Medical Biotechnologies (DIBIMED). Section of Anestesia, Analgesia, Intensive Care and Emergency. Policlinico Paolo Giaccone, University of Palermo, Via del vespro 129, 90127, Palermo, Italy.
BMC Anesthesiol. 2018 Aug 16;18(1):106. doi: 10.1186/s12871-018-0574-9.
Palliative care is patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering when "curative" therapies are futile. In the Intensive Care Unit (ICU), critically ill patients receive life-sustaining therapies with the goal of restoring or maintaining organ function. Palliative Care in the ICU is a widely discussed topic and it is increasingly applied in clinics. It encompasses symptoms control and end-of-life management, communication with relatives and setting goals of care ensuring dignity in death and decision-making power. However, effective application of Palliative Care in ICU presupposes specific knowledge and training which anesthesiologists and critical care physicians may lack. Moreover, logistic issues such protocols for patients' selection, application models and triggers for consultation of external experts are still matter of debate.The aim of this review is to provide the anesthesiologists and intensivists an overview of the aims, current evidence and practical advices about the application of palliative care in ICU.
姑息治疗是以患者和家庭为中心的护理，当“治愈性”治疗无效时，通过预测、预防和治疗痛苦来优化生活质量。在重症监护病房（ICU），重症患者接受维持生命的治疗，目标是恢复或维持器官功能。ICU中的姑息治疗是一个广泛讨论的话题，并且在临床上越来越多地得到应用。它包括症状控制和临终管理、与亲属沟通以及设定护理目标，确保死亡时的尊严和决策权。然而，在ICU中有效应用姑息治疗需要特定的知识和培训，而麻醉医生和重症医生可能缺乏这些。此外，诸如患者选择方案、应用模式以及外部专家会诊触发因素等后勤问题仍存在争议。本综述的目的是为麻醉医生和重症医生提供有关在ICU中应用姑息治疗的目标、当前证据和实用建议的概述。
