End-of-life care in the intensive care unit: state of the art in 2006.

Evidence suggests that change is occurring in end-of-life care in the intensive care unit (ICU). There is a growing need and appreciation for the importance of education for the multidisciplinary team, but particularly for physicians, in gaining communication skills to improve the quality of end-of-life care and provide palliative care in the ICU. Studies have indicated that families are unhappy with the communication they receive when a family member is in the ICU. Evidence also suggests that families want to be involved in decisions about their loved one's care. Interventions have been tested in numerous ICUs that others can evaluate for application to their own facility in an attempt to create a global standard for end-of-life care in the ICU. Quality indicators have been defined, and an audit tool can help assess levels of performance.

[1]  M. Levy,et al.  Visiting hours policies in New England intensive care units: Strategies for improvement , 2007, Critical care medicine.

[2]  Daniel E. Ray,et al.  Proposed quality measures for palliative care in the critically ill: a consensus from the Robert Wood Johnson Foundation Critical Care Workgroup. , 2006, Critical care medicine.

[3]  G. Rubenfeld,et al.  Missed opportunities during family conferences about end-of-life care in the intensive care unit. , 2005, American journal of respiratory and critical care medicine.

[4]  J. Curtis,et al.  Interventions to improve care during withdrawal of life-sustaining treatments. , 2005, Journal of palliative medicine.

[5]  M. Antonelli,et al.  Challenges in End-of-Life Care in the ICU: Statement of the 5th International Consensus Conference in Critical Care: Brussels, Belgium, April 2003: Executive Summary , 2004, Intensive care medicine.

[6]  G. Rubenfeld,et al.  Family satisfaction with family conferences about end-of-life care in the intensive care unit: Increased proportion of family speech is associated with increased satisfaction* , 2004, Critical care medicine.

[7]  R. Hall,et al.  Simple changes can improve conduct of end-of-life care in the intensive care unit , 2004, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[8]  M. Antonelli,et al.  Challenges in end-of-life care in the ICU , 2004, Intensive Care Medicine.

[9]  Amber E Barnato,et al.  Use of intensive care at the end of life in the United States: An epidemiologic study* , 2004, Critical care medicine.

[10]  T. Gilmer,et al.  Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial. , 2003, JAMA.

[11]  M. Levy,et al.  Quality indicators for end-of-life care in the intensive care unit* , 2003, Critical care medicine.

[12]  J. Raboud,et al.  Explicit approach to rounds in an ICU improves communication and satisfaction of providers , 2003, Intensive Care Medicine.

[13]  D. Cook,et al.  Dying in the ICU: perspectives of family members. , 2003, Chest.

[14]  A. Gafni,et al.  The seriously ill hospitalized patient: preferred role in end-of-life decision making? , 2003, Journal of critical care.

[15]  M. Campbell,et al.  Impact of a proactive approach to improve end-of-life care in a medical ICU. , 2003, Chest.

[16]  G. Guyatt,et al.  Cardiopulmonary resuscitation directives on admission to intensive-care unit: an international observational study , 2001, The Lancet.

[17]  C. Sprung,et al.  Recommendations for end-of-life care in the intensive care unit: The Ethics Committee of the Society of Critical Care Medicine , 2001, Critical care medicine.

[18]  A. Abernethy,et al.  Families looking back: One year after discussion of withdrawal or withholding of life-sustaining support , 2001, Critical care medicine.

[19]  F Lemaire,et al.  Meeting the needs of intensive care unit patient families: a multicenter study. , 2001, American journal of respiratory and critical care medicine.

[20]  S Chevret,et al.  Half the families of intensive care unit patients experience inadequate communication with physicians , 2000, Critical care medicine.

[21]  T. Nilstun,et al.  Withdrawal of life support--who should decide? Differences in attitudes among the general public, nurses and physicians. , 1999, Intensive care medicine.

[22]  J. Luce,et al.  A national survey of end-of-life care for critically ill patients. , 1998, American journal of respiratory and critical care medicine.

[23]  Gary Fischer,et al.  Opening the Black Box: How Do Physicians Communicate about Advance Directives? , 1998, Annals of Internal Medicine.