• Jennifer B Seaman, Amber E Barnato, Susan M Sereika, Mary Beth Happ, and Judith A Erlen.
• The CRISMA Laboratory (Clinical Research, Investigation, and Systems Modeling of Acute Illness), Department of Critical Care Medicine, University of Pittsburgh School of Medicine, 607 Scaife Hall, 3550 Terrace St., Pittsburgh, PA 15261, USA. Electronic address: jbs31@pitt.edu.
• Heart Lung. 2017 Jan 1; 46 (1): 18-23.

ObjectiveDescribe patterns of palliative care service consultation among a sample of ICU patients at high risk of dying.BackgroundPatients receiving mechanical ventilation (MV) face threats to comfort, social connectedness and dignity due to pain, heavy sedation and physical restraint. Palliative care consultation services may mitigate poor outcomes.MethodsFrom a dataset of 1440 ICU patients with ≥2 days of MV and ≥12 h of sustained wakefulness, we identified those at high risk of dying and/or who died and assessed patterns of sub-specialty palliative care consultation.ResultsAbout half (773/1440 [54%]) were at high risk of dying or died, 73 (9.4%) of whom received palliative care consultation. On average, referral occurred after 62% of the ICU stay had elapsed. Primary reason for consult was clarification of goals of care (52/73 [72.2%]).ConclusionsAmong MV ICU patients at high risk of dying, palliative care service consultation occurs late and infrequently, suggesting a role for earlier palliative care.Copyright © 2016 Elsevier Inc. All rights reserved.

27 keywords...

hide…