Palliative care teams in the intensive care unit: a randomised, controlled, feasibility study
Open accessAbstract
Objectives To determine whether palliative care teams can improve patient, family and staff satisfaction for patients receiving end-of-life care in the intensive care unit and reduce surrogate markers of health care costs. Design Randomised controlled, feasibility study. Setting 14-bed general ICU over 29 months in 2006-2008. Participants Patients admitted with a terminal or preterminal condition, for whom the treating intensivist considered that escalating or continuing treatment was unlikely to achieve significant improvement in the patient's clinical condition. Intervention A consultation from a palliative care team, in addition to usual ICU end-of-life care. Main outcome measures ICU and hospital length of stay, and changes in composite scores of satisfaction obtained from questionnaires administered to families, nursing staff and intensivists. Results The study was constrained by significant logistical and methodological problems, including low recruitment and questionnaire completion rates, and the lack of an available validated questionnaire. From a total of 2009 admissions over a 29-month period, 20 patients were enrolled, 10 in each group. There were significant differences in baseline characteristics. There were no statistically significant differences between those who had a consultation with the palliative care team and those who did not in median ICU length of stay (3 days v 5 days, P=0.97), median hospital length of stay (5 days v 11 days, P=0.44), or changes in…
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Most patients respond to the prone position with improved oxygenation and may also have improved lung compliance.
“Most patients respond to the prone position with improved oxygenation and may also have improved lung compliance (457-459).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [458]
There was no benefit demonstrated on family satisfaction, ICU days, or hospital days.
“There was no benefit demonstrated on family satisfaction, ICU days, or hospital days.”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [543]
Palliative care meetings failed to show benefit in decreasing anxiety and depression in surrogate decision makers in the intervention group but did increase PTSD symptoms.
“Palliative care meetings failed to show benefit in decreasing anxiety and depression in surrogate decision makers in the intervention group but did increase post-traumatic stress disorder (PTSD) symptoms.”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [543]
None of the studies evaluated critical patient-centered outcomes such as QoL, physical or cognitive recovery, psychological outcomes, or symptoms.
“Various outcome measures are reported but none of the studies evaluated critical patient-centered outcomes such as QoL, physical or cognitive recovery, psychological outcomes, or symptoms.”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [543]
Criteria for patient inclusion and the interventions in these studies demonstrate significant heterogeneity.
“Criteria for patient inclusion and the interventions in these studies demonstrate significant heterogeneity.”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [543]
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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000005337 · Cited by 2,935 · see citing works
Factors Associated With Family Satisfaction With End-of-Life Care in the ICU
Hinkle, L. J., Bosslet, G. T., & Torke, A. M. (2015) · Chest · doi:10.1378/chest.14-1098 · Cited by 142 · see citing works
Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Intensive Care Medicine · doi:10.1007/s00134-021-06506-y · Cited by 5,082 · see citing works
- Authors
- Cheung, W., Aggarwal, G., Fugaccia, E., Thanakrishnan, G., Milliss, D., Anderson, R., Stock, D., Bird, H., Tan, J., & Fryc, A. C.
- Affiliations
- Concord Repatriation General Hospital (AU)
- Corresponding author
- Cheung, Winston
- Venue
- Critical Care and Resuscitation
- Publisher
- Elsevier BV
- Published
- 2010-03
- Volume
- 12
- Issue
- 1
- Pages
- 28-35
- ISSN
- 1441-2772 (ISSN-L)
- OpenAlex
- W38869006
- Cited by
- 42
- References
- 0
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 5 · 2015: 4 · 2014: 4 · 2013: 4 · 2012: 2
- FWCI
- 1.91
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Critical Care and Resuscitation (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
- Keywords
- palliative care team, intensive care unit, end-of-life care, terminal illness, family satisfaction, staff satisfaction, length of hospital stay, health care costs, feasibility, palliative care consultation
- MeSH terms
- Aged, Aged, 80 and over, Cost-Benefit Analysis, Family, Feasibility Studies, Female, Humans, Intensive Care Units, Male, Palliative Care, Patient Care Team, Referral and Consultation, Terminal Care, Health Care Costs, Patient Satisfaction, Withholding Treatment
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