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Record Nr. |
UNINA9910502648903321 |
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Titolo |
Palliative care in cardiac intensive care units / / edited by Massimo Romanò |
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Pubbl/distr/stampa |
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Cham, Switzerland : , : Springer, , [2021] |
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©2021 |
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ISBN |
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Descrizione fisica |
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1 online resource (202 pages) |
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Disciplina |
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Soggetti |
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Cardiac intensive care |
Medicina intensiva en cardiologia |
Tractament pal·liatiu |
Llibres electrònics |
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Lingua di pubblicazione |
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Formato |
Materiale a stampa |
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Livello bibliografico |
Monografia |
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Nota di contenuto |
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Intro -- Foreword -- Preface -- Acknowledgements -- Contents -- About the Author -- 1: Epidemiology and Patterns of Care in Modern Cardiac Intensive Care Units -- 1.1 Introduction -- 1.2 Is There a Background for the Evolution of CICU? From the Blitz-3 to Modern International CICU Registries -- 1.3 Aging, Comorbidity, and the Risk of Futility in CICU -- 1.4 The COVID-19 Tsunami and Its Effect on CICU -- 1.5 Conclusions -- References -- 2: The Intensive and Advanced Treatments in the Cardiac Intensive Care Units -- 2.1 Introduction -- 2.2 Cardiac Arrest and Post-cardiac Arrest Syndrome -- 2.3 Advanced Heart Failure and End-Stage Heart Failure -- 2.4 Cardiogenic Shock (CS) and Low-Output Syndrome -- 2.5 Mechanical Circulatory Supports (MCSs) -- 2.6 Heart Replacement Therapies -- 2.7 Cardiac Implanted Electronic Devices (CIEDs) -- 2.8 Palliative Care in CICU -- 2.9 Palliative Inotrope Care -- References -- 3: Symptom Assessment and Management -- 3.1 The Cardiologist's Palliative Competencies -- 3.2 Measuring a Symptom -- 3.2.1 Dyspnea -- 3.2.2 Pain -- 3.2.3 Thirst -- 3.3 Cognitive and Mood Disorders -- 3.3.1 Fatigue -- 3.3.2 Gastrointestinal Symptoms -- References -- 4: The Meanings of Prognosis: When and How to Discuss It? -- 4.1 Introduction -- 4.2 |
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Deciding Between Prognosis and Uncertainty -- 4.3 Criteria for Prognosis Definition -- 4.4 Communicating Prognosis -- 4.5 Barriers to Communication -- 4.5.1 The Disease -- 4.5.2 The Patient -- 4.5.3 Treatment Approach -- 4.5.4 The Doctor -- 4.6 Conclusions -- References -- 5: Informed Consent, Advance Directives, and Shared Care Planning -- 5.1 Introduction -- 5.2 Legal and Ethical Aspects -- 5.3 Shared Care Planning and Advance Directives in Cardiology -- 5.4 Conclusions -- References -- 6: Withholding or Withdrawing Life-Sustaining Treatments -- 6.1 Introduction. |
6.2 Forgoing Life-Sustaining Treatments: The Clinical Practice -- 6.3 Physician Preferences -- 6.4 Withdrawing Life-Sustaining Treatment: Arguments in Favor -- 6.5 Withholding Life-Sustaining Treatment: Arguments in Favor -- 6.6 Withdrawing or Withholding Life-Sustaining Treatments: Means or Goals? -- 6.7 Forgoing Life-Sustaining Treatments: How to Do -- 6.7.1 Ethical Principles -- 6.7.2 Decision to Forgo Life-Sustaining Treatments: Theoretical Approach -- 6.7.3 Decision to Forgo Life-Sustaining Treatments: The Goals -- 6.7.4 Withdrawing Life-Sustaining Treatments: Basics in Clinical Practice -- 6.8 Conclusions -- References -- 7: Deactivation of Cardiac Implantable Electronic Devices (CIEDs) at the End of Life -- 7.1 Introduction -- 7.2 Implantable Cardioverter-Defibrillators (ICDs) -- 7.2.1 Ethical Problems -- 7.2.2 Information and Patient Awareness -- 7.2.3 The Opinion of Physicians and Nurses -- 7.3 Cardiac Pacemaker (PM)-Cardiac Resynchronisation Therapy-Pacemaker (CRT-P) -- 7.4 Conclusions -- References -- 8: Withdrawal of Mechanical Circulatory Support in the Cardiac Intensive Care Unit -- 8.1 Introduction -- 8.2 Why Is LST Withdrawal Challenging? -- 8.3 Ethical Consideration in Withdrawal of Cardiopulmonary Devices -- 8.4 Approach to Specific Life-Sustaining Treatments -- 8.5 Mechanical Ventilation -- 8.6 MCSDs (IABP, Impella, ECMO, and LVAD) -- 8.7 The Role of Palliative Care Consultation -- 8.8 Conclusion -- References -- 9: Do-Not-Attempt-Resuscitation Orders in the Cardiac Intensive Care Unit -- 9.1 Cardiopulmonary Resuscitation -- 9.2 Intensive Care Medicine: A Balance of Risks and Benefits -- 9.3 The Utility of DNACPR Orders -- 9.4 The Unintended Consequences of DNACPR Orders -- 9.5 Shared Decision-Making -- 9.6 Moving Beyond DNACPR Towards Resuscitation Plans -- 9.7 Conclusions -- References. |
10: Palliative Sedation in Cardiac Intensive Care Units: When, Why, How -- 10.1 Introduction -- 10.2 The Definition of Palliative Sedation -- 10.3 Indications for Palliative Sedation -- 10.4 Types of Palliative Sedation -- 10.5 Pharmacological Aspects -- 10.6 Ethical Aspects in Palliative Sedation -- 10.7 The Ethical Difference Between Palliative Sedation and Euthanasia -- 10.8 The Relationship Between Palliative Sedation and Forgoing Treatment -- 10.9 Correct Decision-Making Management -- References -- 11: Nursing and the End of Life in Cardiac Intensive Care Unit (CICU) -- 11.1 Introduction -- 11.2 Decision-Making and Discussions About Goals of Care -- 11.3 Person- and Family-Centred Care -- 11.4 Care Planning -- 11.5 Palliative Interventions -- 11.6 Preparing for Withdrawal of Life-Sustaining Treatment or Imminent Death -- 11.7 Meeting Psychosocial and Spiritual Needs -- 11.8 Unanticipated Death -- 11.9 Care After Death -- References -- 12: Conflict Management in the Cardiac Intensive Care Unit -- 12.1 Conflicts in the Cardiac Intensive Care Unit: Definitions, Background, and Examples -- 12.2 Conflict Characteristics -- 12.3 Managing Conflicts: Can We Be Better In Conflicts? -- 12.4 Involvement of a Palliative Care Team: Experiences -- 12.5 How to Turn Conflict into an Opportunity for Improvement? -- 12.6 Conclusion -- References -- 13: Ethical Considerations in the Use |
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of Technology in the Cardiac Intensive Care Unit -- 13.1 Introduction -- 13.2 Utility Versus Futility -- 13.3 When to Start and When to Stop: Withholding Versus Withdrawing -- 13.4 Hype, Hope, and Hubris -- 13.5 The External Drivers of Too Much Technology -- 13.6 The Internal Drivers of Too Much Technology -- 13.7 Conclusion -- References -- 14: Physician Education and Training in Palliative Care: A New Challenge in Modern Cardiac Intensive Care. |
14.1 Introduction: The Modern Cardiac Intensive Care Unit -- 14.2 Palliative Care in the CICU -- 14.3 Primary and Specialty Palliative Care in the CICU -- 14.4 Physician Education and Training -- 14.5 Primary Palliative Care Learning Objectives -- 14.6 Communication -- 14.7 Decision-Making -- 14.8 Therapies and Interventions Unique to CICU -- 14.9 Shared Decision-Making -- 14.10 Symptom Management -- 14.11 Teaching Modalities -- 14.12 Bedside Teaching -- 14.13 Didactics -- 14.14 Case Based -- 14.15 Conclusion -- References. |
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