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BACKGROUND These recommendations have been developed to improve the care of intensive care unit (ICU) patients during the dying process. The recommendations build on those published in 2003 and highlight recent developments in the field from a U.S. perspective. They do not use an evidence grading system because most of the recommendations are based on(More)
STUDY OBJECTIVES To assess the impact of a proactive case finding approach to end-of-life care for critically ill patients experiencing global cerebral ischemia (GCI) after cardiopulmonary resuscitation and multiple organ system failure (MOSF) in comparison to historical control subjects. DESIGN Comparative study of retrospective and prospective cohorts.(More)
OBJECTIVES To compare usual care with a proactive case-finding approach for critically ill patients with terminal dementia using an inpatient palliative care service. DESIGN Prospective comparison to historical control. SETTING Urban, university-affiliated hospital. PATIENTS Total of 52 men and women with end-stage dementia, 26 subjects in each(More)
OBJECTIVE To describe and analyze patient responses to rapid terminal weaning from mechanical ventilation. DESIGN A prospective, descriptive, correlational study. SETTING An urban, university-affiliated, trauma/emergency hospital. PATIENTS A convenience sample of 31 adult patients experiencing withdrawal of mechanical ventilation. INTERVENTIONS(More)
OBJECTIVE To review the use of screening criteria (also known as "triggers") as a mechanism for engaging palliative care consultants to assist with care of critically ill patients and their families in the ICU. DATA SOURCES We searched the MEDLINE database from inception to December 2012 for all English-language articles using the terms "trigger,"(More)
OBJECTIVE To describe models used in successful clinical initiatives to improve the quality of palliative care in critical care settings. DATA SOURCES We searched the MEDLINE database from inception to April 2010 for all English language articles using the terms "intensive care," "critical care," or "ICU" and "palliative care"; we also hand-searched(More)
OBJECTIVE Although successful models for palliative care delivery and quality improvement in the intensive care unit have been described, their applicability in surgical intensive care unit settings has not been fully addressed. We undertook to define specific challenges, strategies, and solutions for integration of palliative care in the surgical intensive(More)
OBJECTIVES To describe unique features of neurocritical illness that are relevant to provision of high-quality palliative care; to discuss key prognostic aids and their limitations for neurocritical illnesses; to review challenges and strategies for establishing realistic goals of care for patients in the neuro-ICU; and to describe elements of best practice(More)
BACKGROUND This consensus statement was developed based on the understanding that patients with advanced lung or heart disease are not being treated consistently and effectively for relief of dyspnea. METHODS A panel of experts was convened. After a literature review, the panel developed 23 statements covering five domains that were considered relevant to(More)
Pain, dyspnea, and thirst are three of the most prevalent, intense, and distressing symptoms of intensive care unit (ICU) patients. In this report, the interdisciplinary Advisory Board of the Improving Palliative Care in the ICU (IPAL-ICU) Project brings together expertise in both critical care and palliative care along with current information to address(More)