Palliative care is becoming increasingly important in intensive care units. The main goal of palliative treatment is to improve quality of life in patients with critical and life-threatening conditions when curative therapies can no longer be achieved. Treatment is not limited to end-of-life care, but also includes relief of distressing symptoms such as pain, nausea, vomiting, dyspnea, delirium or anxiety, as well as communication with patients and their families. Defining patient-centred goals of care together with patients, relatives and intensive care staff supports shared decision-making. Aspects of palliative care can be integrated in the ICU in different ways. The "integrative model" presumes that all patients with critical illness may benefit from palliative care principles and interventions practiced by the ICU team. The "consultative model" involves palliative care consultants in the care of ICU patients with palliative care need that may be identified using trigger criteria. This article gives an overview on different aspects of palliative care in intensive care units and provides practical advice for the implementation of palliative care in the ICU.
Die Bedeutung moderner Intensivmedizin für schwerstkranke Patienten ist unbestritten. Dennoch stellt sich die Frage nach der Sinnhaftigkeit maximaler Intensivtherapie, wenn sie zwar eine Lebensverlängerung erreicht, aber die Lebensqualität stark beeinträchtigt. Mit dem Wissen und der Akzeptanz, realistische Therapieziele im Sinne des Patienten festzulegen, gewinnen palliativmedizinische Aspekte auf der Intensivstation zunehmend an Bedeutung.
Georg Thieme Verlag KG Stuttgart · New York.