Palliative Care in the Cardiac Intensive Care Unit

Naib, Tara; Lahewala, Sopan; Arora, Shilpkumar; Gidwani, Umesh

doi:10.1016/j.amjcard.2014.12.023

Cited by 33 publications

(16 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A total of 19 studies were excluded: 5 had conflicting objectives for the PC intervention in the ICU (Lin et al, 2009; Lim et al, 2013; Obermeyer et al, 2014; Kross et al, 2014; Binney et al, 2014), and 14 employed an inappropriate methodology (Lonberger et al, 1997; Nelson & Danis, 2001; Mularski & Osborne, 2003; Paice et al, 2004; Lloyd et al, 2004; Sprung et al, 2008; Klein et al, 2012; Strand & Billings, 2012; Aslakson et al, 2014; Hui et al, 2014; Naib et al, 2015; Barnato et al, 2014; Jang et al, 2015; Kim et al, 2015).…”

Section: Resultsmentioning

confidence: 99%

Palliative care for terminally ill patients in the intensive care unit: Systematic review and metaanalysis

2016

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

Palliative care for terminally ill patients in the intensive care unit: Systematic review and metaanalysis

2016

View full text Add to dashboard Cite

show abstract

“…An appropriate scoring system should be characterized by a slope in score/ outcome probability able to promote intensive care and palliative care integration continuously, and across different levels of patient's severity life status is still lacking in clinical practice, even for patients who are not hospitalized [8]. For this reason, as in other papers [20,21], the outcome observed at the ICU discharge has been used as a surrogate for end-of-life condition for patients both enrolled in the pilot study and for those enrolled in this prospective validation. Notably, despite death in the ICU certainly being associated with the end-of-life of patients, ICU survival does not necessarily exclude the end-of-life condition or the requirement of palliative care [22].…”

Section: Discussionmentioning

confidence: 99%

Validation of END-of-life ScorING-system to identify the dying patient: a prospective analysis

et al. 2020

View full text Add to dashboard Cite

Background:The "END-of-Life ScorING-System" (ENDING-S) was previously developed to identify patients at highrisk of dying in the ICU and to facilitate a practical integration between palliative and intensive care. The aim of this study is to prospectively validate ENDING-S in a cohort of long-term critical care patients. Materials and methods: Adult long-term ICU patients (with a length-of-stay> 4 days) were considered for this prospective multicenter observational study. ENDING-S and SOFA score were calculated daily and evaluated against the patient's ICU outcome. The predictive properties were evaluated through a receiver operating characteristic (ROC) analysis.Results: Two hundred twenty patients were enrolled for this study. Among these, 21.46% died during the ICU stay. ENDING-S correctly predicted the ICU outcome in 71.4% of patients. Sensitivity, specificity, positive and negative predictive values associated with the previously identified ENDING-S cut-off of 11.5 were 68.1, 72.3, 60 and 89.3%, respectively. ROC-AUC for outcome prediction was 0.79 for ENDING-S and 0.88 for SOFA in this cohort. Conclusions: ENDING-S, while not as accurately as in the pilot study, demonstrated acceptable discrimination properties in identifying long-term ICU patients at very high-risk of dying. ENDING-S may be a useful tool aimed at facilitating a practical integration between palliative, end-of-life and intensive care.

show abstract

“…Palliative care education and training must be a standard among clinicians who are involved in cardiovascular intensive care. 55,56 Care of acute cardiovascular patients extends beyond the ICCU. The ICCU team should bring its expertise to other wards and other settings, typically providing acute cardiovascular care consultations to inpatients with a potential need for ICCU admission, overseeing and facilitating ICCU triage decisions, especially when ICCU resources are constrained.…”

Section: ) Iccus and Interaction With Other Specialtiesmentioning

confidence: 99%

“…Palliative care education and training must be a standard among clinicians who are involved in cardiovascular intensive care. 55,56…”

Section: ) Iccus and Interaction With Other Specialtiesmentioning

confidence: 99%

Editor’s Choice - Acute Cardiovascular Care Association Position Paper on Intensive Cardiovascular Care Units: An update on their definition, structure, organisation and function

Bonnefoy‐Cudraz

Bueno²,

Casella

et al. 2017

European Heart Journal: Acute Cardiovascular Care

View full text Add to dashboard Cite

Acute cardiovascular care has progressed considerably since the last position paper was published 10 years ago. It is now a well-defined, complex field with demanding multidisciplinary teamworking. The Acute Cardiovascular Care Association has provided this update of the 2005 position paper on acute cardiovascular care organisation, using a multinational working group. The patient population has changed, and intensive cardiovascular care units now manage a large range of conditions from those simply requiring specialised monitoring, to critical cardiovascular diseases with associated multi-organ failure. To describe better intensive cardiovascular care units case mix, acuity of care has been divided into three levels, and then defining intensive cardiovascular care unit functional organisation. For each level of intensive cardiovascular care unit, this document presents the aims of the units, the recommended management structure, the optimal number of staff, the need for specially trained cardiologists and cardiovascular nurses, the desired equipment and architecture, and the interaction with other departments in the hospital and other intensive cardiovascular care units in the region/area. This update emphasises cardiologist training, referring to the recently updated Acute Cardiovascular Care Association core curriculum on acute cardiovascular care. The training of nurses in acute cardiovascular care is additionally addressed. Intensive cardiovascular care unit expertise is not limited to within the unit's geographical boundaries, extending to different specialties and subspecialties of cardiology and other specialties in order to optimally manage the wide scope of acute cardiovascular conditions in frequently highly complex patients. This position paper therefore addresses the need for the inclusion of acute cardiac care and intensive cardiovascular care units within a hospital network, linking university medical centres, large community hospitals, and smaller hospitals with more limited capabilities.

show abstract

Palliative Care in the Cardiac Intensive Care Unit

Cited by 33 publications

References 9 publications

Palliative care for terminally ill patients in the intensive care unit: Systematic review and metaanalysis

Palliative care for terminally ill patients in the intensive care unit: Systematic review and metaanalysis

Validation of END-of-life ScorING-system to identify the dying patient: a prospective analysis

Editor’s Choice - Acute Cardiovascular Care Association Position Paper on Intensive Cardiovascular Care Units: An update on their definition, structure, organisation and function

Contact Info

Product

Resources

About