Palliative Care in the Intensive Care Unit (ICU)

  • Rebecca A. Aslakson
  • J. Randall CurtisEmail author
Reference work entry


Palliative care is a medical specialty and philosophy of care that focuses on reducing suffering among patients with serious illness and their family members, regardless of disease diagnosis or prognosis. As critical illness is often life-threatening and confers significant disease-related symptom burdens, palliative care and palliative care specialists can aid in identifying goals of care, reducing symptom burden, and improving quality of life among intensive care unit (ICU) patients and their family members. Palliative care in the ICU can be delivered by the ICU team itself, specialist-trained palliative care consultants, or a combination of both. Though initial reports describing end-of-life care practices in the ICU were published in 1976, the modern era of palliative care research in the ICU began in the early 2000s. Since 2010, the Improving Palliative Care in the ICU (IPAL-ICU) Advisory Board has published a series of articles exploring opportunities and barriers to palliative care delivery in the ICU, particularly across different ICU types, ICU providers, and ICU patient populations. Furthermore, initiatives to improve delivery of “family-centered care” in the ICU frequently also correlate with palliative care practices. To date, over 40 palliative care and palliative care-related interventions targeting ICU patients and families have been trialed and published with results showing mixed effectiveness on outcomes such as ICU length of stay, patient and family symptoms, and family member satisfaction; several randomized trials provide important insights into interventions that improve patient and family outcomes as well as those that do not.


  1. Accreditation Council for Graduate Medical Education. Program requirements for graduate medical education in hospice and palliative medicine. 2018. Available from Accessed 15 April 2018.
  2. Adhikari NKJ, et al. Self-reported depressive symptoms and memory complaints in survivors five years after ARDS. Chest. 2011;140(6):1484–93.PubMedCrossRefPubMedCentralGoogle Scholar
  3. Andereck WS, et al. Seeking to reduce nonbeneficial treatment in the ICU: an exploratory trial of proactive ethics intervention*. Crit Care Med. 2014;42(4):824–30.PubMedCrossRefPubMedCentralGoogle Scholar
  4. Anderson WG, et al. Posttraumatic stress and complicated grief in family members of patients in the intensive care unit. J Gen Intern Med. 2008;23(11):1871–6.PubMedPubMedCentralCrossRefGoogle Scholar
  5. Angus DC, et al. Use of intensive care at the end of life in the United States: an epidemiologic study. Crit Care Med. 2004;32(3):638–43.PubMedCrossRefPubMedCentralGoogle Scholar
  6. Apatira L, et al. Hope, truth, and preparing for death: perspectives of surrogate decision makers. Ann Intern Med. 2008;149(12):861–8.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Aslakson RA, Bridges JF. Assessing the impact of palliative care in the intensive care unit through the lens of patient-centered outcomes research. Curr Opin Crit Care. 2013;19(5):504–10.PubMedCrossRefPubMedCentralGoogle Scholar
  8. Aslakson RA, et al. Surgical intensive care unit clinician estimates of the adequacy of communication regarding patient prognosis. Crit Care. 2010;14(6):R218.PubMedPubMedCentralCrossRefGoogle Scholar
  9. Aslakson RA, Curtis JR, Nelson JE. The changing role of palliative care in the ICU. Crit Care Med. 2014a;42(11):2418–28.PubMedPubMedCentralCrossRefGoogle Scholar
  10. Aslakson R, et al. Evidence-based palliative care in the intensive care unit: a systematic review of interventions. J Palliat Med. 2014b;17(2):219–35.PubMedPubMedCentralCrossRefGoogle Scholar
  11. Aslakson RA, et al. Developing a research agenda for integrating palliative care into critical care and pulmonary practice to improve patient and family outcomes. J Palliat Med. 2017;20(4):329–43.PubMedPubMedCentralCrossRefGoogle Scholar
  12. Azoulay E, et al. Half the families of intensive care unit patients experience inadequate communication with physicians. Crit Care Med. 2000;28(8):3044–9.PubMedCrossRefPubMedCentralGoogle Scholar
  13. Azoulay E, et al. Impact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients: a multicenter, prospective, randomized, controlled trial. Am J Respir Crit Care Med. 2002;165(4):438–42.PubMedCrossRefPubMedCentralGoogle Scholar
  14. Azoulay E, et al. Prevalence and factors of intensive care unit conflicts: the conflicus study. Am J Respir Crit Care Med. 2009;180(9):853–60.PubMedCrossRefPubMedCentralGoogle Scholar
  15. Back AL, Arnold RM, Quill TE. Hope for the best, and prepare for the worst. Ann Intern Med. 2003;138(5):439–43.PubMedCrossRefPubMedCentralGoogle Scholar
  16. Back AL, et al. Approaching difficult communication tasks in oncology. CA Cancer J Clin. 2005;55(3):164–77.PubMedCrossRefPubMedCentralGoogle Scholar
  17. Barr J, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41(1):263–306.PubMedCrossRefPubMedCentralGoogle Scholar
  18. Black MD, et al. A multifaceted intervention to improve compliance with process measures for ICU clinician communication with ICU patients and families. Crit Care Med. 2013;41(10):2275–83.PubMedCrossRefPubMedCentralGoogle Scholar
  19. Boyd EA, et al. “It’s not just what the doctor tells me:” factors that influence surrogate decision-makers’ perceptions of prognosis. Crit Care Med. 2010;38(5):1270–5.PubMedPubMedCentralCrossRefGoogle Scholar
  20. Boyle M, et al. The effect of chronic pain on health related quality of life amongst intensive care survivors. Aust Crit Care. 2004;17(3):104–6. 108-13PubMedCrossRefPubMedCentralGoogle Scholar
  21. Breen CM, et al. Conflict associated with decisions to limit life-sustaining treatment in intensive care units. J Gen Intern Med. 2001;16(5):283–9.PubMedPubMedCentralCrossRefGoogle Scholar
  22. Browning DM, et al. Difficult conversations in health care: cultivating relational learning to address the hidden curriculum. Acad Med. 2007;82(9):905–13.PubMedCrossRefPubMedCentralGoogle Scholar
  23. Buchman TG. Surgeons and their patients near the end of life. Crit Care Med. 2010;38(3):995–6.PubMedCrossRefPubMedCentralGoogle Scholar
  24. Buchman TG, et al. Who should manage the dying patient?: rescue, shame, and the surgical ICU dilemma. J Am Coll Surg. 2002;194(5):665–73.PubMedCrossRefPubMedCentralGoogle Scholar
  25. Buchman TG, et al. Families’ perceptions of surgical intensive care. J Am Coll Surg. 2003;196(6):977–83.PubMedCrossRefPubMedCentralGoogle Scholar
  26. Burns JP, et al. Results of a clinical trial on care improvement for the critically ill. Crit Care Med. 2003;31(8):2107–17.PubMedCrossRefPubMedCentralGoogle Scholar
  27. Cameron JI, et al. One-year outcomes in caregivers of critically ill patients. N Engl J Med. 2016;374(19):1831–41.PubMedCrossRefPubMedCentralGoogle Scholar
  28. Campbell ML, Guzman JA. Impact of a proactive approach to improve end-of-life care in a medical ICU. Chest. 2003;123(1):266–71.PubMedCrossRefPubMedCentralGoogle Scholar
  29. Campbell ML, Guzman JA. A proactive approach to improve end-of-life care in a medical intensive care unit for patients with terminal dementia. Crit Care Med. 2004;32(9):1839–43.PubMedCrossRefPubMedCentralGoogle Scholar
  30. Carlet J, et al. Challenges in end-of-life care in the ICU. Statement of the 5th international consensus conference in critical care: Brussels, Belgium, April 2003. Intensive Care Med. 2004;30(5):770–84.PubMedCrossRefPubMedCentralGoogle Scholar
  31. Carlson RW, Devich L, Frank RR. Development of a comprehensive supportive care team for the hopelessly ill on a university hospital medical service. JAMA. 1988;259(3):378–83.PubMedCrossRefPubMedCentralGoogle Scholar
  32. Carson SS, et al. Effect of palliative care-led meetings for families of patients with chronic critical illness: a randomized clinical trial. JAMA. 2016;316(1):51–62.PubMedPubMedCentralCrossRefGoogle Scholar
  33. Cassell J, et al. Surgeons, intensivists, and the covenant of care: administrative models and values affecting care at the end of life- updated...including commentary by Buchman TG and Stewart RM. Crit Care Med. 2003a;31(5):1551–9.PubMedCrossRefPubMedCentralGoogle Scholar
  34. Cassell J, et al. Surgeons, intensivists, and the covenant of care: administrative models and values affecting care at the end of life – updated. Crit Care Med. 2003b;31(5):1551–7. Discussion 1557-9.PubMedCrossRefPubMedCentralGoogle Scholar
  35. Choi J, et al. Caregivers of the chronically critically ill after discharge from the intensive care unit: six months’ experience. Am J Crit Care. 2011;20(1):12–22. Quiz 23.PubMedPubMedCentralCrossRefGoogle Scholar
  36. Choi J, et al. Self-reported physical symptoms in intensive care unit (ICU) survivors: pilot exploration over four months post-ICU discharge. J Pain Symptom Manag. 2014;47(2):257–70.CrossRefGoogle Scholar
  37. Clarke EB, et al. Quality indicators for end-of-life care in the intensive care unit. Crit Care Med. 2003;31(9):2255–62.PubMedCrossRefPubMedCentralGoogle Scholar
  38. Committee on Approaching Death: Addressing Key End of Life Issues; Institute of Medicine. Dying in America: improving quality and honoring individual preferences near the end of life. Washington, DC. Copyright 2015 by the National Academy of Sciences. All rights reserved: National Academies Press; 2015.Google Scholar
  39. Cox CE, et al. Differences in one-year health outcomes and resource utilization by definition of prolonged mechanical ventilation: a prospective cohort study. Crit Care. 2007;11(1):R9.PubMedPubMedCentralCrossRefGoogle Scholar
  40. Cox CE, et al. Surviving critical illness: acute respiratory distress syndrome as experienced by patients and their caregivers. Crit Care Med. 2009;37(10):2702–8.PubMedPubMedCentralCrossRefGoogle Scholar
  41. Cox CE, et al. Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation. Crit Care Med. 2012;40(8):2327–34.PubMedCrossRefPubMedCentralGoogle Scholar
  42. Cruzan v. Director, Missouri Department of Health, in 110 S Ct 2841; 1990.Google Scholar
  43. Curtis JR, et al. Missed opportunities during family conferences about end-of-life care in the intensive care unit. Am J Respir Crit Care Med. 2005;171(8):844–9.PubMedCrossRefPubMedCentralGoogle Scholar
  44. Curtis JR, et al. Intensive care unit quality improvement: a “how-to” guide for the interdisciplinary team. Crit Care Med. 2006;34(1):211–8.PubMedCrossRefPubMedCentralGoogle Scholar
  45. Curtis JR, et al. Integrating palliative and critical care: evaluation of a quality-improvement intervention. Am J Respir Crit Care Med. 2008;178(3):269–75.PubMedPubMedCentralCrossRefGoogle Scholar
  46. Curtis JR, et al. Effect of a quality-improvement intervention on end-of-life care in the intensive care unit: a randomized trial. Am J Respir Crit Care Med. 2011;183(3):348–55.PubMedCrossRefPubMedCentralGoogle Scholar
  47. Curtis JR, et al. Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: a randomized trial. JAMA. 2013;310(21):2271–81.PubMedPubMedCentralCrossRefGoogle Scholar
  48. Curtis JR, et al. Randomized trial of communication facilitators to reduce family distress and intensity of end-of-life care. Am J Respir Crit Care Med. 2016;193(2):154–62.PubMedPubMedCentralCrossRefGoogle Scholar
  49. Daly K, et al. The effect of two nursing interventions on families of ICU patients. Clin Nurs Res. 1994;3(4):414–22.PubMedCrossRefPubMedCentralGoogle Scholar
  50. Daly BJ, et al. Effectiveness trial of an intensive communication structure for families of long-stay ICU patients. Chest. 2010;138(6):1340–8.PubMedPubMedCentralCrossRefGoogle Scholar
  51. Davidson JE, et al. Guidelines for family-centered care in the neonatal, pediatric, and adult ICU. Crit Care Med. 2017;45(1):103–28.PubMedCrossRefPubMedCentralGoogle Scholar
  52. Davydow DS, et al. Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry. 2008;30(5):421–34.PubMedPubMedCentralCrossRefGoogle Scholar
  53. Davydow DS, et al. Depression in general intensive care unit survivors: a systematic review. Intensive Care Med. 2009;35(5):796–809.PubMedCrossRefPubMedCentralGoogle Scholar
  54. de Miranda S, et al. Postintensive care unit psychological burden in patients with chronic obstructive pulmonary disease and informal caregivers: a multicenter study. Crit Care Med. 2011;39(1):112–8.PubMedCrossRefPubMedCentralGoogle Scholar
  55. DeCato TW, et al. Hospital variation and temporal trends in palliative and end-of-life care in the ICU. Crit Care Med. 2013;41(6):1405–11.PubMedPubMedCentralCrossRefGoogle Scholar
  56. Dowdy DW, et al. Quality of life in adult survivors of critical illness: a systematic review of the literature. Intensive Care Med. 2005;31(5):611–20.PubMedCrossRefPubMedCentralGoogle Scholar
  57. Dowdy DW, et al. Quality of life after acute respiratory distress syndrome: a meta-analysis. Intensive Care Med. 2006;32(8):1115–24.PubMedCrossRefPubMedCentralGoogle Scholar
  58. Evans LR, et al. Surrogate decision-makers’ perspectives on discussing prognosis in the face of uncertainty. Am J Respir Crit Care Med. 2009;179(1):48–53.PubMedCrossRefPubMedCentralGoogle Scholar
  59. Fan E, et al. Venovenous extracorporeal membrane oxygenation for acute respiratory failure: a clinical review from an international group of experts. Intensive Care Med. 2016;42(5):712–24.PubMedCrossRefPubMedCentralGoogle Scholar
  60. Fassier T, et al. Care at the end of life in critically ill patients: the European perspective. Curr Opin Crit Care. 2005;11(6):616–23.PubMedCrossRefPubMedCentralGoogle Scholar
  61. Field BE, Devich LE, Carlson RW. Impact of a comprehensive supportive care team on management of hopelessly ill patients with multiple organ failure. Chest. 1989;96(2):353–6.PubMedCrossRefPubMedCentralGoogle Scholar
  62. Fried C. Editorial: terminating life support: out of the closet. N Engl J Med. 1976;295(7):390–1.PubMedCrossRefPubMedCentralGoogle Scholar
  63. Frontera JA, et al. Integrating palliative care into the care of neurocritically ill patients: a report from the improving palliative care in the ICU project advisory board and the center to advance palliative care. Crit Care Med. 2015;43(9):1964–77.PubMedPubMedCentralCrossRefGoogle Scholar
  64. Goldsmith B, et al. Variability in access to hospital palliative care in the United States. J Palliat Med. 2008;11(8):1094–102.PubMedPubMedCentralCrossRefGoogle Scholar
  65. Goodman DC, Esty AR, Fisher ES, et al. Trends and variation in end-of-life care for medicare beneficiaries with severe chronic illness. Hanover: The Dartmouth Institute for Health Policy and Clinical Practice; 2011.Google Scholar
  66. Griffin JP, et al. Palliative care consultation, quality-of-life measurements, and bereavement for end-of-life care in patients with lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):404s–22s.PubMedCrossRefPubMedCentralGoogle Scholar
  67. Hall RI, Rocker GM, Murray D. Simple changes can improve conduct of end-of-life care in the intensive care unit. Can J Anaesth. 2004;51(6):631–6.PubMedCrossRefPubMedCentralGoogle Scholar
  68. Halpern SD, et al. An official American Thoracic Society/American Association of Critical-Care Nurses/American College of Chest Physicians/Society of Critical Care Medicine policy statement: the choosing wisely(r) top 5 list in critical care medicine. Am J Respir Crit Care Med. 2014;190(7):818–26.PubMedCrossRefPubMedCentralGoogle Scholar
  69. Hatler CW, et al. The effect of completing a surrogacy information and decision-making tool upon admission to an intensive care unit on length of stay and charges. J Clin Ethics. 2012;23(2):129–38.PubMedPubMedCentralGoogle Scholar
  70. Herridge MS, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348(8):683–93.PubMedCrossRefPubMedCentralGoogle Scholar
  71. Herridge MS, et al. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011;364(14):1293–304.PubMedCrossRefPubMedCentralGoogle Scholar
  72. Holloran SD, et al. An educational intervention in the surgical intensive care unit to improve ethical decisions. Surgery. 1995;118(2):294–8. discussion 298-9.PubMedCrossRefPubMedCentralGoogle Scholar
  73. Holloway RG, et al. Palliative and end-of-life care in stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(6):1887–916.PubMedCrossRefPubMedCentralGoogle Scholar
  74. Hough CL, et al. Death rounds: end-of-life discussions among medical residents in the intensive care unit. J Crit Care. 2005;20(1):20–5.PubMedCrossRefPubMedCentralGoogle Scholar
  75. In re Quinlan, in 755 A2A 647. 1976, cert denied: NJ.Google Scholar
  76. Iwashyna TJ, et al. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010;304(16):1787–94.PubMedPubMedCentralCrossRefGoogle Scholar
  77. Jones C, et al. Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial. Crit Care. 2010;14(5):R168.PubMedPubMedCentralCrossRefGoogle Scholar
  78. Jubran A, et al. Depressive disorders during weaning from prolonged mechanical ventilation. Intensive Care Med. 2010;36(5):828–35.PubMedPubMedCentralCrossRefGoogle Scholar
  79. Kelley AS, Morrison RS. Palliative care for the seriously ill. N Engl J Med. 2015;373(8):747–55.PubMedPubMedCentralCrossRefGoogle Scholar
  80. Khandelwal N, et al. Estimating the effect of palliative care interventions and advance care planning on ICU utilization: a systematic review. Crit Care Med. 2015;43(5):1102–11.PubMedPubMedCentralCrossRefGoogle Scholar
  81. Kirchhoff KT, Beckstrand RL. Critical care nurses’ perceptions of obstacles and helpful behaviors in providing end-of-life care to dying patients. Am J Crit Care. 2000;9(2):96–105.PubMedPubMedCentralGoogle Scholar
  82. Krimshtein NS, et al. Training nurses for interdisciplinary communication with families in the intensive care unit: an intervention. J Palliat Med. 2011;14(12):1325–32.PubMedPubMedCentralCrossRefGoogle Scholar
  83. Lanken PN, et al. An official American Thoracic Society clinical policy statement: palliative care for patients with respiratory diseases and critical illnesses. Am J Respir Crit Care Med. 2008;177(8):912–27.PubMedCrossRefPubMedCentralGoogle Scholar
  84. Lautrette A, et al. A communication strategy and brochure for relatives of patients dying in the ICU. N Engl J Med. 2007;356(5):469–78.PubMedCrossRefPubMedCentralGoogle Scholar
  85. Lilley EJ, et al. Palliative care interventions for surgical patients: a systematic review. JAMA Surg. 2016;151(2):172–83.PubMedCrossRefPubMedCentralGoogle Scholar
  86. Lilley EJ, et al. Palliative care in surgery: defining the research priorities. J Palliat Med. 2017;20:702–9.PubMedCrossRefPubMedCentralGoogle Scholar
  87. Lilly CM, et al. An intensive communication intervention for the critically ill. Am J Med. 2000;109(6):469–75.PubMedCrossRefPubMedCentralGoogle Scholar
  88. Lilly CM, et al. Intensive communication: four-year follow-up from a clinical practice study. Crit Care Med. 2003;31(5 Suppl):S394–9.PubMedCrossRefPubMedCentralGoogle Scholar
  89. Luce JM. A history of resolving conflicts over end-of-life care in intensive care units in the United States. Crit Care Med. 2010;38(8):1623–9.PubMedCrossRefPubMedCentralGoogle Scholar
  90. Lustbader DR, et al. Physician reimbursement for critical care services integrating palliative care for patients who are critically ill. Chest. 2012;141(3):787–92.PubMedPubMedCentralCrossRefGoogle Scholar
  91. Mahler DA, et al. American College of Chest Physicians consensus statement on the management of dyspnea in patients with advanced lung or heart disease. Chest. 2010;137(3):674–91.PubMedCrossRefPubMedCentralGoogle Scholar
  92. Majesko A, et al. Identifying family members who may struggle in the role of surrogate decision maker. Crit Care Med. 2012;40(8):2281–6.PubMedPubMedCentralCrossRefGoogle Scholar
  93. Mark NM, et al. Global variability in withholding and withdrawal of life-sustaining treatment in the intensive care unit: a systematic review. Intensive Care Med. 2015;41(9):1572–85.PubMedCrossRefPubMedCentralGoogle Scholar
  94. McCannon JB, et al. Augmenting communication and decision making in the intensive care unit with a cardiopulmonary resuscitation video decision support tool: a temporal intervention study. J Palliat Med. 2012;15(12):1382–7.PubMedPubMedCentralCrossRefGoogle Scholar
  95. McDonagh JR, et al. Family satisfaction with family conferences about end-of-life care in the intensive care unit: increased proportion of family speech is associated with increased satisfaction. Crit Care Med. 2004;32(7):1484–8.PubMedCrossRefPubMedCentralGoogle Scholar
  96. Meyer EC, et al. Difficult conversations: improving communication skills and relational abilities in health care. Pediatr Crit Care Med. 2009;10(3):352–9.PubMedCrossRefPubMedCentralGoogle Scholar
  97. Mosenthal AC, et al. Integrating palliative care in the surgical and trauma intensive care unit: a report from the Improving Palliative Care in the Intensive Care Unit (IPAL-ICU) Project Advisory Board and the Center to Advance Palliative Care. Crit Care Med. 2012;40(4):1199–206.PubMedPubMedCentralCrossRefGoogle Scholar
  98. Mularski RA, et al. Proposed quality measures for palliative care in the critically ill: a consensus from the Robert Wood Johnson Foundation Critical Care Workgroup. Crit Care Med. 2006;34(11 Suppl):S404–11.PubMedCrossRefPubMedCentralGoogle Scholar
  99. Mularski RA, et al. An official American Thoracic Society workshop report: assessment and palliative management of dyspnea crisis. Ann Am Thorac Soc. 2013;10(5):S98–106.PubMedCrossRefPubMedCentralGoogle Scholar
  100. National Consensus Project for Quality Palliative Care, editor. Clinical practice guidelines for quality palliative care. 3rd ed. Pittsburgh: National Consensus Project for Quality Palliative Care; 2013.Google Scholar
  101. Needham DM, et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference. Crit Care Med. 2012;40(2):502–9.PubMedCrossRefPubMedCentralGoogle Scholar
  102. Nelson JE. Identifying and overcoming the barriers to high-quality palliative care in the intensive care unit. Crit Care Med. 2006;34(11 Suppl):S324–31.PubMedCrossRefPubMedCentralGoogle Scholar
  103. Nelson JE, et al. The symptom burden of chronic critical illness. Crit Care Med. 2004;32(7):1527–34.PubMedCrossRefPubMedCentralGoogle Scholar
  104. Nelson JE, et al. Brain dysfunction – another burden for the chronically critically ill. Arch Intern Med. 2006a;166(18):1993–9.PubMedCrossRefPubMedCentralGoogle Scholar
  105. Nelson JE, et al. Improving comfort and communication in the ICU: a practical new tool for palliative care performance measurement and feedback. Qual Saf Health Care. 2006b;15(4):264–71.PubMedPubMedCentralCrossRefGoogle Scholar
  106. Nelson JE, et al. In their own words: patients and families define high-quality palliative care in the intensive care unit. Crit Care Med. 2010a;38(3):808–18.PubMedPubMedCentralCrossRefGoogle Scholar
  107. Nelson JE, et al. Models for structuring a clinical initiative to enhance palliative care in the intensive care unit: a report from the IPAL-ICU Project (Improving Palliative Care in the ICU). Crit Care Med. 2010b;38(9):1765–72.PubMedPubMedCentralCrossRefGoogle Scholar
  108. Nelson JE, et al. Chronic critical illness. Am J Respir Crit Care Med. 2010c;182(4):446–54.PubMedPubMedCentralCrossRefGoogle Scholar
  109. Nelson JE, et al. Integrating palliative care in the ICU: the nurse in a leading role. J Hosp Palliat Nurs. 2011;13(2):89–94.PubMedPubMedCentralCrossRefGoogle Scholar
  110. Nelson JE, et al. Choosing and using screening criteria for palliative care consultation in the ICU: a report from the Improving Palliative Care in the ICU (IPAL-ICU) Advisory Board. Crit Care Med. 2013;41(10):2318–27.PubMedCrossRefPubMedCentralGoogle Scholar
  111. Nelson JE, et al. Integration of palliative care in the context of rapid response: a report from the Improving Palliative Care in the ICU advisory board. Chest. 2015;147(2):560–9.PubMedPubMedCentralCrossRefGoogle Scholar
  112. Nelson JE, et al. The voice of surrogate decision-makers. Family responses to prognostic information in chronic critical illness. Am J Respir Crit Care Med. 2017;196(7):864–72.PubMedPubMedCentralCrossRefGoogle Scholar
  113. Norton SA, et al. Proactive palliative care in the medical intensive care unit: effects on length of stay for selected high-risk patients. Crit Care Med. 2007;35(6):1530–5.PubMedCrossRefPubMedCentralGoogle Scholar
  114. Olson TJP, et al. Surgeon-reported conflict with intensivists about postoperative goals of care. JAMA Surg. 2013;148(1):29–35.CrossRefGoogle Scholar
  115. Optimum care for hopelessly ill patients. A report of the clinical care committee of the Massachusetts General Hospital. N Engl J Med. 1976;295(7):362–4.CrossRefGoogle Scholar
  116. Pandharipande PP, et al. Long-term cognitive impairment after critical illness. N Engl J Med. 2013;369(14):1306–16.PubMedPubMedCentralCrossRefGoogle Scholar
  117. Penrod JD, et al. Implementation and evaluation of a network-based pilot program to improve palliative care in the intensive care unit. J Pain Symptom Manag. 2011;42(5):668–71.CrossRefGoogle Scholar
  118. Penrod JD, et al. Meeting standards of high-quality intensive care unit palliative care: clinical performance and predictors. Crit Care Med. 2012;40(4):1105–12.PubMedPubMedCentralCrossRefGoogle Scholar
  119. Pochard F, et al. Symptoms of anxiety and depression in family members of intensive care unit patients before discharge or death. A prospective multicenter study. J Crit Care. 2005;20(1):90–6.PubMedCrossRefPubMedCentralGoogle Scholar
  120. Pollak KI, et al. Oncologist communication about emotion during visits with patients with advanced cancer. J Clin Oncol. 2007;25(36):5748–52.PubMedCrossRefPubMedCentralGoogle Scholar
  121. Prendergast TJ, Luce JM. Increasing incidence of withholding and withdrawal of life support from the critically ill. Am J Respir Crit Care Med. 1997;155(1):15–20.PubMedCrossRefPubMedCentralGoogle Scholar
  122. Pronovost PJ, et al. Developing and implementing measures of quality of care in the intensive care unit. Curr Opin Crit Care. 2001;7(4):297–303.PubMedCrossRefPubMedCentralGoogle Scholar
  123. Puntillo KA. Pain experiences of intensive care unit patients. Heart Lung. 1990;19(5 Pt 1):526–33.PubMedPubMedCentralGoogle Scholar
  124. Puntillo KA, et al. Symptoms experienced by intensive care unit patients at high risk of dying. Crit Care Med. 2010;38(11):2155–60.PubMedPubMedCentralCrossRefGoogle Scholar
  125. Puntillo K, et al. Palliative care in the ICU: relief of pain, dyspnea, and thirst – a report from the IPAL-ICU Advisory Board. Intensive Care Med. 2014;40(2):235–48.PubMedCrossRefPubMedCentralGoogle Scholar
  126. Quill TE, Abernethy AP. Generalist plus specialist palliative care – creating a more sustainable model. N Engl J Med. 2013;368(13):1173–5.PubMedPubMedCentralCrossRefGoogle Scholar
  127. Ray DE, et al. Care of the critically ill burn patient. An overview from the perspective of optimizing palliative care. Ann Am Thorac Soc. 2017;14(7):1094–102.PubMedPubMedCentralGoogle Scholar
  128. Rodriguez R, et al. Utilization of palliative care consultation service by surgical services. Ann Palliat Med. 2015;4(4):194–9.PubMedPubMedCentralGoogle Scholar
  129. Schenker Y, et al. I don’t want to be the one saying ‘we should just let him die’: intrapersonal tensions experienced by surrogate decision makers in the ICU. J Gen Intern Med. 2012;27(12):1657–65.PubMedPubMedCentralCrossRefGoogle Scholar
  130. Schenker Y, et al. “It hurts to know... and it helps”: exploring how surrogates in the ICU cope with prognostic information. J Palliat Med. 2013;16(3):243–9.PubMedPubMedCentralCrossRefGoogle Scholar
  131. Scheunemann LP, et al. Randomized, controlled trials of interventions to improve communication in intensive care: a systematic review. Chest. 2011;139(3):543–54.PubMedCrossRefPubMedCentralGoogle Scholar
  132. Scheunemann LP, et al. How clinicians discuss critically ill patients’ preferences and values with surrogates: an empirical analysis. Crit Care Med. 2015;43(4):757–64.PubMedPubMedCentralCrossRefGoogle Scholar
  133. Schneiderman LJ, Gilmer T, Teetzel HD. Impact of ethics consultations in the intensive care setting: a randomized, controlled trial. Crit Care Med. 2000;28(12):3920–4.PubMedCrossRefPubMedCentralGoogle Scholar
  134. Schneiderman LJ, et al. Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial. JAMA. 2003;290(9):1166–72.PubMedCrossRefPubMedCentralGoogle Scholar
  135. School, A.H.C.o.t.H.M. A definition of irreversible coma, report of the Ad Hoc Committee of the Harvard Medical School to examine the definition of brain death. JAMA. 1968;205:337–40.CrossRefGoogle Scholar
  136. Schwarze ML, Bradley CT, Brasel KJ. Surgical “buy-in”: the contractual relationship between surgeons and patients that influences decisions regarding life-supporting therapy. Crit Care Med. 2010;38(3):843–8.PubMedPubMedCentralCrossRefGoogle Scholar
  137. Schwarze ML, et al. Surgeons expect patients to buy-in to postoperative life support preoperatively: results of a national survey. Crit Care Med. 2013;41(1):1–8.PubMedPubMedCentralCrossRefGoogle Scholar
  138. Selecky PA, et al. Palliative and end-of-life care for patients with cardiopulmonary diseases: American College of Chest Physicians position statement. Chest. 2005;128(5):3599–610.PubMedCrossRefPubMedCentralGoogle Scholar
  139. Selph RB, et al. Empathy and life support decisions in intensive care units. J Gen Intern Med. 2008;23(9):1311–7.PubMedPubMedCentralCrossRefGoogle Scholar
  140. Siegel MD, et al. Psychiatric illness in the next of kin of patients who die in the intensive care unit. Crit Care Med. 2008;36(6):1722–8.PubMedCrossRefPubMedCentralGoogle Scholar
  141. Silveira MJ, Kim SY, Langa KM. Advance directives and outcomes of surrogate decision making before death. N Engl J Med. 2010;362(13):1211–8.PubMedPubMedCentralCrossRefGoogle Scholar
  142. Sprung CL, et al. End-of-life practices in European intensive care units: the Ethicus study. JAMA. 2003;290(6):790–7.PubMedCrossRefPubMedCentralGoogle Scholar
  143. Sprung CL, et al. The importance of religious affiliation and culture on end-of-life decisions in European intensive care units. Intensive Care Med. 2007;33(10):1732–9.PubMedCrossRefPubMedCentralGoogle Scholar
  144. Stapleton RD, et al. Clinician statements and family satisfaction with family conferences in the intensive care unit. Crit Care Med. 2006;34(6):1679–85.PubMedCrossRefPubMedCentralGoogle Scholar
  145. Studdert DM, et al. Nature of conflict in the care of pediatric intensive care patients with prolonged stay. Pediatrics. 2003a;112(3 Pt 1):553–8.PubMedCrossRefPubMedCentralGoogle Scholar
  146. Studdert DM, et al. Conflict in the care of patients with prolonged stay in the ICU: types, sources, and predictors. Intensive Care Med. 2003b;29(9):1489–97.PubMedCrossRefPubMedCentralGoogle Scholar
  147. Swoboda SM, Lipsett PA. Impact of a prolonged surgical critical illness on patients’ families. Am J Crit Care. 2002;11(5):459–66.PubMedPubMedCentralGoogle Scholar
  148. Teno JM, et al. Change in end-of-life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009. JAMA. 2013;309(5):470–7.PubMedPubMedCentralCrossRefGoogle Scholar
  149. Treece PD, et al. Evaluation of a standardized order form for the withdrawal of life support in the intensive care unit. Crit Care Med. 2004;32(5):1141–8.PubMedCrossRefPubMedCentralGoogle Scholar
  150. Truog RD, et al. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine. Crit Care Med. 2008;36(3):953–63.PubMedCrossRefPubMedCentralGoogle Scholar
  151. Unroe M, et al. One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study. Ann Intern Med. 2010;153(3):167–75.PubMedPubMedCentralCrossRefGoogle Scholar
  152. Van Pelt DC, et al. Informal caregiver burden among survivors of prolonged mechanical ventilation. Am J Respir Crit Care Med. 2007;175(2):167–73.PubMedCrossRefPubMedCentralGoogle Scholar
  153. Villarreal D, et al. A model for increasing palliative care in the intensive care unit: enhancing interprofessional consultation rates and communication. J Pain Symptom Manag. 2011;42(5):676–9.CrossRefGoogle Scholar
  154. West HF, et al. Expressions of nonabandonment during the intensive care unit family conference. J Palliat Med. 2005;8(4):797–807.PubMedCrossRefPubMedCentralGoogle Scholar
  155. White DB, Curtis JR. Establishing an evidence base for physician-family communication and shared decision making in the intensive care unit. Crit Care Med. 2006;34(9):2500–1.PubMedCrossRefPubMedCentralGoogle Scholar
  156. White DB, et al. Toward shared decision making at the end of life in intensive care units: opportunities for improvement. Arch Intern Med. 2007;167(5):461–7.PubMedCrossRefPubMedCentralGoogle Scholar
  157. White DB, et al. Nurse-led intervention to improve surrogate decision making for patients with advanced critical illness. Am J Crit Care. 2012;21(6):396–409.PubMedPubMedCentralCrossRefGoogle Scholar
  158. World Health Organization. 2018. WHO definition of palliative care. Available from: Accessed 15 April 2018.
  159. Wunsch H, et al. Three-year outcomes for Medicare beneficiaries who survive intensive care. JAMA. 2010;303(9):849–56.PubMedCrossRefPubMedCentralGoogle Scholar
  160. Yancy CW, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the Heart Failure Society of America. J Card Fail. 2017;23(8):628–51.PubMedCrossRefPubMedCentralGoogle Scholar
  161. Zier LS, et al. Surrogate decision makers’ interpretation of prognostic information: a mixed-methods study. Ann Intern Med. 2012;156(5):360–6.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Medicine and Division of Primary Care and Population Health, Section of Palliative Care; Department of Anesthesiology, Perioperative and Pain MedicineStanford UniversityStanfordUSA
  2. 2.Division of Pulmonary, Critical Care, and Sleep Medicine, Harborview Medical CenterCambia Palliative Care Center of Excellence, University of WashingtonSeattleUSA

Personalised recommendations