Zusammenfassung
Die Bedeutung moderner Intensivmedizin für schwerstkranke Patienten ist unbestritten.
Dennoch stellt sich die Frage nach der Sinnhaftigkeit maximaler Intensivtherapie,
wenn sie zwar eine Lebensverlängerung erreicht, aber die Lebensqualität stark beeinträchtigt.
Mit dem Wissen und der Akzeptanz, realistische Therapieziele im Sinne des Patienten
festzulegen, gewinnen palliativmedizinische Aspekte auf der Intensivstation zunehmend
an Bedeutung.
Abstract
Palliative care is becoming increasingly important in intensive care units. The main
goal of palliative treatment is to improve quality of life in patients with critical
and life-threatening conditions when curative therapies can no longer be achieved.
Treatment is not limited to end-of-life care, but also includes relief of distressing
symptoms such as pain, nausea, vomiting, dyspnea, delirium or anxiety, as well as
communication with patients and their families. Defining patient-centred goals of
care together with patients, relatives and intensive care staff supports shared decision-making.
Aspects of palliative care can be integrated in the ICU in different ways. The “integrative
model” presumes that all patients with critical illness may benefit from palliative
care principles and interventions practiced by the ICU team. The “consultative model”
involves palliative care consultants in the care of ICU patients with palliative care
need that may be identified using trigger criteria. This article gives an overview
on different aspects of palliative care in intensive care units and provides practical
advice for the implementation of palliative care in the ICU.
Schlüsselwörter
Palliativmedizin - Intensivstation - Symptomkontrolle - gemeinsame Entscheidungsfindung
- End-of-Life Decisions
Key words
palliative care - ICU - symptom management - shared decision making - end-of-life
decisions
