[Palliative Care in the Intensive Care Unit]

Abstract

The number of deaths in hospitals and intensive care units (ICUs) is rising, with particularly high mortality rates reported among ventilated ICU patients and those with mechanical circulatory support. Palliative care aims to improve the quality of life for patients with serious illnesses and their families. It focuses on addressing physical, psychological, social, and spiritual symptoms, clarifying care goals, and supporting communication within the healthcare team and with patients and their families. The multi-professional palliative care team typically includes physicians, nurses, social workers, psychologists, physiotherapists, chaplains, creative therapists and volunteers. General palliative care is provided by all healthcare workers, whereas specialist palliative care involves palliative care units, inpatient consultation teams, and outpatient services (specialist ambulatory palliative care). Despite the beneficial effects of palliative care in the ICU on care trajectories, symptom control, and care satisfaction, its practice is not standardized in German ICUs, and no specific guidelines exist for ICU palliative care. To identify patients in need of palliative care and facilitate timely integration, collaborative training, ward rounds, or trigger factors can be effective. In the German healthcare insurance system, specialist palliative care within ICU treatment is covered by operation and procedure codes.