Die Intensivmedizin verfolgt mit Maximaltherapie das Ziel einer Genesung, häufig unter
Inkaufnahme von Einschränkungen der Lebensqualität. Bei Intensivpatient*innen mit
kritischen Erkrankungen kann die Einbindung der Palliativversorgung hilfreich sein,
um die physischen, psychischen, sozialen und spirituellen Symptomebenen multiprofessionell
zu adressieren. Studien zeigen positive Auswirkungen, sodass Empfehlungen ausgesprochen
wurden.
Abstract
The number of deaths in hospitals and intensive care units (ICUs) is rising, with
particularly high mortality rates reported among ventilated ICU patients and those
with mechanical circulatory support. Palliative care aims to improve the quality of
life for patients with serious illnesses and their families. It focuses on addressing
physical, psychological, social, and spiritual symptoms, clarifying care goals, and
supporting communication within the healthcare team and with patients and their families.
The multi-professional palliative care team typically includes physicians, nurses,
social workers, psychologists, physiotherapists, chaplains, creative therapists and
volunteers. General palliative care is provided by all healthcare workers, whereas
specialist palliative care involves palliative care units, inpatient consultation
teams, and outpatient services (specialist ambulatory palliative care). Despite the
beneficial effects of palliative care in the ICU on care
trajectories, symptom control, and care satisfaction, its practice is not standardized
in German ICUs, and no specific guidelines exist for ICU palliative care. To identify
patients in need of palliative care and facilitate timely integration, collaborative
training, ward rounds, or trigger factors can be effective. In the German healthcare
insurance system, specialist palliative care within ICU treatment is covered by operation
and procedure codes.
Schlüsselwörter
Intensivmedizin - Palliativmedizin - Interdisziplinarität - patientenzentrierte Medizin
- Lebensqualität
