Mehta Ankita, Bullock Karen, Gustin Jillian L, Hadler Rachel A, Nelson Judith E, Rosa William E, Seaman Jennifer B, Varner-Perez Shelley E, White Douglas B
Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Social Work, Boston College, Chestnut Hill, Massachusetts, USA.
J Palliat Med. 2025 Aug 8. doi: 10.1177/10966218251366072.
The intensive care unit (ICU) is distinct in population, culture, and palliative care needs. Critical illness and ICU stays can be extremely distressing for patients and their loved ones. Providing palliative care in the ICU, although a standard component of comprehensive care delivery, involves understanding the individual culture of each specific ICU, collaboration with multiple providers, and interfacing with surrogate decision makers while patients may not be able to communicate and are undergoing interventions that are unfamiliar to them and loved ones. These top ten tips aim to support palliative care clinicians providing consultation in ICUs. Specifically, these tips address initial relationship building with ICU clinicians and teams to foster effective collaboration, establishing goals of care by assessing health-related values, explaining treatment options, individualizing prognostic discussions, and managing end-of-life symptoms for patients while in the ICU and throughout ICU discharge transition.
重症监护病房（ICU）在患者群体、文化及姑息治疗需求方面独具特点。危重病况以及在ICU的住院经历对患者及其亲人而言可能极其痛苦。在ICU提供姑息治疗，尽管是综合医疗服务的标准组成部分，但需要了解每个特定ICU的独特文化，与多名医护人员协作，并与替代决策者进行沟通，而此时患者可能无法交流，且正在接受他们及亲人都不熟悉的治疗干预措施。这十大要点旨在为在ICU提供咨询服务的姑息治疗临床医生提供支持。具体而言，这些要点涉及与ICU临床医生和团队建立初步关系以促进有效协作，通过评估与健康相关的价值观来确立治疗目标，解释治疗方案，使预后讨论个性化，以及在患者处于ICU期间及整个ICU出院过渡阶段管理其临终症状。
