Recommendations for end-of-life care in the intensive care unit: A consensus statement by the American College of Critical Care Medicine

• DOI: 10.1097/ccm.0b013e3181659096
• Publication Date: 2009-03-05T15:27:48Z
• Authors: Robert D. Truog; Margaret L. Campbell; J Randall Curtis; Curtis E. Haas; John M. Luce; Gordon D. Rubenfeld; Cynda Hylton Rushton; David C. Kaufman
• Keywords: End-of-Life Care; Modalities

Background: These recommendations have been developed to improve the care of intensive unit (ICU) patients during dying process. The build on those published in 2003 and highlight recent developments field from a U.S. perspective. They do not use an evidence grading system because most are based ethical legal principles that derived empirically evidence. Principal Findings: Family-centered care, which emphasizes importance social structure within embedded, has emerged as comprehensive ideal for managing end-of-life ICU. ICU clinicians should be competent all aspects this including practical withdrawing different modalities life-sustaining treatment sedatives, analgesics, nonpharmacologic approaches easing suffering Several key concepts play foundational role guiding distinctions between withholding treatments, actions killing allowing die, consequences intended vs. merely foreseen (the doctrine double effect). Improved communication with family shown patient outcomes. Other knowledge unique includes notifying families patient's death compassionate discussing options organ donation. End-of-life continues even after patient, ICUs consider developing bereavement programs support both needs clinical staff. Finally, agenda improving guide research, quality improvement efforts, educational curricula. Conclusions: is emerging area expertise demands same high level competence other areas practice.