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End-of-Life Care for Critically Ill Patients with Heart Failure: A Multidisciplinary Viewpoint from the Intensive Care Unit

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Acute Heart Failure

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Abstract

Care near the end of life (EOL) for critically ill patients is emerging as an essential task in cardiology and heart failure (HF) management. Professional recommendations were recently published on this topic and a consensus exists that research and debate in this area need further progress. In the field of critical care medicine, development of research about EOL care was substantial during the last decade. The growing incidence of decisions to forgo life-sustaining therapies (DFLSTs) stimulated ethical debates and led to official statements of European and American intensive care medicine societies. This chapter discusses the interdisciplinary aspects of EOL care by reviewing the critical care medicine literature concerning EOL care in the intensive care unit (ICU), for the benefit of physicians involved in EOL care for critically ill patients with HF. First, EOL decisions in the ICU, their incidence, and the legal/ethical background of the decision-making process leading to DFLSTs are reviewed, with comparison with data available about patients with HF.

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Authors and Affiliations

  1. Medical and Respiratory Intensive Care Unit, Croix Rousse Hospital, Lyon, France

    Thomas Fassier MD

  2. Medical Intensive Care, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France

    Elie Azoulay MD, PhD

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Editors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Lariboisière University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Diderot, Paris, France

    Alexandre Mebazaa MD, PhD (Professor of Medicine) (Professor of Medicine)

  2. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    Mihai Gheorghiade MD, FACC (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service) (Professor of Medicine and Surgery, Associate Chief, Division of Cardiology and Chief, Cardiology Clinical Service)

  3. Department of Cardiology Centre d’Investigation Clinique (CIC), INSERM U-684, Centre Hospitalier Universitaire, University Henri Poincaré, Nancy, France

    Faiez M. Zannad MD, PhD, FESC (Professor of Medicine) (Professor of Medicine)

  4. Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

  5. Cooper Heart Institute, Cooper University Hospital, Camden, NJ, USA

    Joseph E. Parrillo MD (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director) (Professor of Medicine, Chief, Department of Medicine Edward D. Viner MD Chair, Department of Medicine and Director)

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Fassier, T., Azoulay, E. (2008). End-of-Life Care for Critically Ill Patients with Heart Failure: A Multidisciplinary Viewpoint from the Intensive Care Unit. In: Mebazaa, A., Gheorghiade, M., Zannad, F.M., Parrillo, J.E. (eds) Acute Heart Failure. Springer, London. https://doi.org/10.1007/978-1-84628-782-4_64

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