Gupta N, Gupta R, Gupta A. Rationale for integration of palliative care in the medical intensive care: A narrative literature review. World J Crit Care Med 2022; 11(6): 342-348 [PMID: 36439323 DOI: 10.5492/wjccm.v11.i6.342]
Corresponding Author of This Article
Anju Gupta, MBBS, MD, DNB, Assistant Professor, Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Ansari Nagar, Delhi 110029, India. dranjugupta2009@rediffmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Nov 9, 2022; 11(6): 342-348 Published online Nov 9, 2022. doi: 10.5492/wjccm.v11.i6.342
Rationale for integration of palliative care in the medical intensive care: A narrative literature review
Nishkarsh Gupta, Raghav Gupta, Anju Gupta
Nishkarsh Gupta, Department of Anesthesiology, All India Institute of Medical Sciences, Delhi 110029, India
Raghav Gupta, Department of Onco-Anesthesiology and Palliative Medicine, All India Institute of Medical Sciences, Delhi 110029, India
Anju Gupta, Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Delhi 110029, India
Author contributions: Gupta A contributed equally to this work; Gupta A and Gupta N designed the research study; Gupta N, Gupta A and Gupta R performed the research and drafted the paper; Gupta A and Gupta N edited the manuscript; All authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anju Gupta, MBBS, MD, DNB, Assistant Professor, Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Ansari Nagar, Delhi 110029, India. dranjugupta2009@rediffmail.com
Received: March 10, 2022 Peer-review started: March 10, 2022 First decision: April 13, 2022 Revised: May 1, 2022 Accepted: September 7, 2022 Article in press: September 7, 2022 Published online: November 9, 2022
Abstract
Despite the remarkable technological advancement in the arena of critical care expertise, the mortality of critically ill patients remains high. When the organ functions deteriorate, goals of care are not fulfilled and life-sustaining treatment becomes a burden on the patient and caregivers, then it is the responsibility of the physician to provide a dignified end to life, control the symptoms of the patient and provide psychological support to the family members. Palliative care is the best way forward for these patients. It is a multidimensional specialty which emphasizes patient and family-based care and aims to improve the quality of life of patients and their caregivers. Although intensive care and palliative care may seem to be at two opposite ends of the spectrum, it is necessary to amalgamate the postulates of palliative care in intensive care units to provide holistic care and best benefit patients admitted to intensive care units. This review aims to highlight the need for an alliance of palliative care with intensive care in the present era, the barriers to it, and models proposed for their integration and various ethical issues.
Core Tip: Critical care and palliative care may seem to be mutually exclusive, but the amalgamation of the two provides the best combination of care to the patients needing intensive care. Palliative care has several beneficial roles in intensive care, such as symptom control, end-of-life discussions, and providing psychological support to patients’ caregivers. However, there are several barriers to its implementation. These can be overcome by education and awareness improvement, capacity building, and developing a national-level framework policy for incorporating palliative care with intensive care.
