Der Klinikarzt 2012; 41(5): 229-232
DOI: 10.1055/s-0032-1316503
Schwerpunkt
© Georg Thieme Verlag Stuttgart · New York

Palliativmedizin bei fortgeschrittenen internistischen Erkrankungen – State of the Art

Palliative Care in Patients with Advanced Lung, Heart or Kidney Failure
Claudia Bausewein
1   King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, London
› Author Affiliations
Further Information

Publication History

Publication Date:
04 June 2012 (online)

Palliativmedizin wurde in den letzten Jahren ein fester Bestandteil des deutschen Gesundheitswesens. Traditionell werden vor allem Patienten mit Tumorerkrankungen palliativmedizinisch betreut. Patienten mit weit fortgeschrittenen Lungen-, Herz- und Nierenversagen haben vergleichbare Symptombelastung und Palliativbedürfnisse, aber unterschiedliche Krankheitsverläufe, die durch intermittierende Verschlechterungen charakterisiert sind. Palliativmedizinische Versorgungskonzepte müssen entsprechend angepasst werden, und eine enge Kooperation der einzelnen Fachdisziplinen ist nötig.

Over the last years, palliative care became part of the German health care system. Traditionally, most patients under palliative care suffered from a malignancy. Patients with advanced lung, heart or kidney failure have similar symptom burden and palliative care needs as oncological patients towards the end of life but different disease trajectories which are characterized by intermittent deteriorations. Palliative care concepts need to be adapted for these patients and close cooperation with other disciplines is necessary.

 
  • Literatur

  • 1 Statistisches Bundesamt. De Statis Todesursachen. [updated 22/01/12/] 2012
  • 2 Bausewein C, Booth S, Gysels M et al. Understanding breathlessness: cross-sectional comparison of symptom burden and palliative care needs in chronic obstructive pulmonary disease and cancer. J Palliat Med 2010; 13: 1109-1118
  • 3 Gysels M, Higginson IJ. Access to services for patients with chronic obstructive pulmonary disease: the invisibility of breathlessness. J Pain Symptom Manage 2008; 36: 451-460
  • 4 Boyd KJ, Murray SA, Kendall M et al. Living with advanced heart failure: a prospective, community based study of patients and their carers. Eur J Heart Fail 2004; 6: 585-591
  • 5 Selman L, Harding R, Beynon T et al. Improving end-of-life care for patients with chronic heart failure: „Let's hope it'll get better, when I know in my heart of hearts it won't“. Heart 2007; 93: 963-967
  • 6 Murtagh FE, Addington-Hall JM, Edmonds PM et al. Symptoms in advanced renal disease: a cross-sectional survey of symptom prevalence in stage 5 chronic kidney disease managed without dialysis. J Palliat Med 2007; 10: 1266-1276
  • 7 Murtagh FE, Marsh JE, Donohoe P et al. Dialysis or not? A comparative survival study of patients over 75 years with chronic kidney disease stage 5. Nephrol Dial Transplant 2007; 22: 1955-1962
  • 8 Lynn J, Adamson DM. Living well at the End of Life Adapting Health Care to Serious Chronic Illness in Old Age. Santa Monica: RAND Health; 2003
  • 9 Shipman C, Gysels M, White P et al. Improving generalist end of life care: national consultation with practitioners, commissioners, academics, and service user groups. BMJ 2008; 337
  • 10 Murray SA, Kendall M, Grant E et al. Patterns of social, psychological, and spiritual decline toward the end of life in lung cancer and heart failure. J Pain Symptom Manage 2007; 34: 393-402
  • 11 Boyd K, Murray SA. Recognising and managing key transitions in end of life care. BMJ 2010; 341
  • 12 Gaertner J, Wolf J, Hallek M, Glossmann JP, Voltz R. Standardizing integration of palliative care into comprehensive cancer therapy--a disease specific approach. Support Care Cancer 2011; 19: 1037-1043
  • 13 Curtis JR. Palliative and end-of-life care for patients with severe COPD. EurRespirJ 2008; 32: 796-803
  • 14 Small N, Gardiner C, Barnes S et al. Using a prediction of death in the next 12 months as a prompt for referral to palliative care acts to the detriment of patients with heart failure and chronic obstructive pulmonary disease. Palliat Med 2010; 24: 740-741
  • 15 Palliative Care Australia. Palliative Care Service Provision in Australia: A Planning Guide. Palliative Care Australia 2003;
  • 16 Murtagh FE, Preston M, Higginson I. Patterns of dying: palliative care for non-malignant disease. Clin Med 2004; 4: 39-44