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Palliative care: Issues in the intensive care unit in adults

Margaret Isaac, MD
J Randall Curtis, MD, MPH
Section Editors
Polly E Parsons, MD
Maria J Silveira, MD, MA, MPH
Christine Ritchie, MD, MSPH
Deputy Editor
Geraldine Finlay, MD


Death in the ICU often occurs after an acute life-threatening illness or an exacerbation of a chronic life-limiting illness that led to intensive treatment. In most cases, patients in the ICU die after life-sustaining treatments are withdrawn or withheld [1,2]. (See "Withholding and withdrawing ventilatory support in adults in the intensive care unit" and "Ethics in the intensive care unit: Responding to requests for potentially inappropriate therapies in adults".)

When asked, most patients express a preference to die at home [3-5], though logistical and medical issues frequently preclude this from happening. Therefore, increasing attention is being focused on end of life care in the ICU setting. Despite many efforts to improve quality of care, evidence suggests that there is significant variation in quality across hospitals and a lack of significant improvement in palliative care provision in the ICU setting over time [6].

This topic will discuss palliative care issues as they specifically apply to patients admitted to the ICU. Other topics in palliative care and the ICU are covered separately.

(See "Benefits, services, and models of subspecialty palliative care".)

(See "Communication in the ICU: Holding a family meeting".)

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Literature review current through: Nov 2017. | This topic last updated: Oct 27, 2017.
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