Integrating Palliative Care in Intensive Care: A Systematic Review of Outcomes

Márcio Niemeyer Martins de Queiroz Guimarães, Sandra Martins Pereira, Bárbara Antunes, Pablo Hernández-Marrero

Resultado de pesquisarevisão de pares

55 Transferências (Pure)


Background: Integration of palliative care (PC) in intensive care (IC) has been researched. However, little is known on the outcomes of such integration. Aim: To review the literature on integration of PC in IC and identify its outcomes. Methods: Systematic review, following PRISMA 2009 recommendations. Data sources: electronic databases and manual search of PC and IC journals. Inclusion criteria: articles describing empirical studies on integration of PC in IC, with clear outcomes, in English, Portuguese, Spanish, with full-text and references available. Selection, screening and data extraction from articles were independently done by 3 researchers. Results: 2781 articles were screened, 43 were included. 17 articles presented outcomes related to end-of-life (EOL) issues or clinical outcomes (CO): hospital/ICU mortality, hospice discharge, number of PC consultation. 1 article only used nonclinical outcomes (NCO): hospital/ICU length of stay and costs. 10 articles showed CO and NCO. In 15 articles, the integration of PC in IC was based on CO or NCO associated with EOL issues, mainly end-of-life decisions (ELDs). Notably, only 1 article used integration of PC in IC as an approach to improve care and decisions at the EOL; outcomes were based on communications skills, quality of dying and symptom control. Most studies fail to present a clear definition of integration. When present, PC integration outcomes emphasize CO, NCO, and/or EOL issues, but fail to provide an overview of a complete and effective integration of the principles and components of PC in IC, including communication skills, patient-focused medical decision-making, clinical care of patient and family. Conclusions: Evidence on outcomes of integrating PC in IC is limited and heterogeneous and relates mainly to EOL issues and ELDs. More research is needed on integration of PC in IC and its outcomes. Acknowledgments: Fundação Grünenthal; Fundação Merck, Sharp and Dohme; and PDSE-CAPES n.88881.134394/2016-01.
Idioma originalEnglish
Estado da publicaçãoPublicado - 28 abr. 2018

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