Villanova University M. Louise Fitzpatrick College of Nursing, Villanova, PA, USA.
Beth Israel Deaconess Medical Center, Boston, MA, USA.
Neurocrit Care. 2024 Dec;41(3):749-759. doi: 10.1007/s12028-024-02064-5. Epub 2024 Aug 5.
Neurologically critically ill patients present with unique disease trajectories, prognostic uncertainties, and challenges to end-of-life (EOL) care. Acute brain injuries place these patients at risk for underrecognized symptoms and unmet EOL management needs, which can negatively affect their quality of care and lead to complicated grief in surviving loved ones. To care for patients nearing the EOL in the neurointensive care unit, health care clinicians must consider neuroanatomic localization, barriers to symptom assessment and management, unique aspects of the dying process, and EOL management needs.
We aim to define current best practices, barriers, and future directions for EOL care of the neurologically critically ill patient.
神经危重症患者具有独特的疾病轨迹、预后不确定性以及临终关怀挑战。急性脑损伤使这些患者面临未被识别的症状和未满足的临终管理需求的风险,这可能会对他们的护理质量产生负面影响,并导致幸存亲人的复杂悲痛。为了在神经重症监护病房照顾接近生命终点的患者,临床医生必须考虑神经解剖定位、症状评估和管理的障碍、临终过程的独特方面以及临终管理需求。
我们旨在定义目前神经危重症患者临终关怀的最佳实践、障碍和未来方向。