• Surg. Clin. North Am. · Dec 2017

    Review

    Goals of Care and End of Life in the ICU.

    • Ana Berlin.
    • Department of Surgery, Rutgers New Jersey Medical School, Medical Science Building G-506, 185 South Orange Avenue, Newark, NJ 07103, USA. Electronic address: Ana.Berlin@njms.rutgers.edu.
    • Surg. Clin. North Am. 2017 Dec 1; 97 (6): 1275-1290.

    AbstractDespite advances in surgical critical care, critical illness remains traumatic and has long-term adverse sequelae. Unrealistic expectations and erroneous assumptions about outcomes acceptable to patients have been identified as drivers of goal-discordant treatment. Goal setting in the ICU begins with compassionately delivered, accurate, and honest prognostic information. Through skilled communication and shared decision making, clinicians forge a mutual understanding of patient values and priorities and the role of therapeutic options in achieving patient goals. Ensuring that treatment is goal-concordant and meets physical, psychosocial, existential, and spiritual needs is crucial for attaining optimal patient and caregiver outcomes, independent of survival.Copyright © 2017 Elsevier Inc. All rights reserved.

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