Full Description
This book analyzes the main topics of Palliative Care in Cardiac Intensive Care Units (CICU), from the changing epidemiology of patients admitted to the ICU, to the main clinical and ethical issues.
The changing epidemiology of patients has led to new and emerging patient needs at the end of life. Care has shifted from acute coronary syndrome patients towards elderly patients, with a high prevalence of non-ischemic cardiovascular diseases and a high burden of non-cardiovascular comorbid conditions: both increase the susceptibility of patients to developing life-threatening critical conditions. These conditions are associated with a significant symptom burden, high mortality rate, and increased length of stay.
The main new challenges involve shared decision-making, symptom control (pain, dyspnea, etc.), and ethical issues (withholding/withdrawing life sustaining treatments, deactivation of implanted cardiac devices, palliative sedation), all of which necessitate formal education on end-of-life care.
Written by opinion leaders in their respective fields, who share their experience with improving the cultural and clinical competence of medical/nursing teams, this volume is chiefly intended for cardiologists, anesthesiologists, palliative care doctors and nursing staff.
Contents
1. Epidemiology and patterns of care in the modern Cardiac Intensive Care Units.- 2. The intensive and advanced treatments in the Cardiac Intensive Care Units.- 3. Symptoms assessment and management.- 4. The meanings of prognosis: when and how to discuss it?.- 5. Informed consent, advance directives and shared care planning.- 6. Withholding or withdrawing life sustaining treatments.- 7. Deactivation of cardiac implanted electronic devices (CIEDs)at the end of life.- 8. Withdrawal of Mechanical Circulatory Support in the Cardiac Intensive Care Unit.- 9. Do not attempt resuscitation orders in CICU.- 10. Palliative sedation in CICU: when, how, why.- 11. Nursing and the end of life in Cardiac Intensive Care Unit.- 12. Conflict management in CICU.- 13. Ethical considerations in the use of Technology in the CICU.- 14. Physician education and training in Palliative Care: a new challenge in modern Cardiac Intensive Care Unit.
