Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey

Santi Maurizio Raineri, Andrea Cortegiani, Antonino Giarratano, Cesare Gregoretti, Sebastiano Mercadante, Sebastiano Mercadante, Vincenzo Russotto

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3 Citazioni (Scopus)

Abstract

Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36â45 years of age (34%) and catholic (66%). Almost 70% of responders declared that palliative/supportive care are applied in their ICU in case of futility of intensive treatments. Decision on withdrawing/withholding of life-sustaining treatments resulted from team consensus in most cases (58%). In more than 70% of respondersâ ICUs, there is no collaboration with palliative/supportive care experts. Systematic recording of most frequent symptoms experienced by critically ill patients (e.g., pain, dyspnea, thirst) was not common. Vasopressors, extracorporeal therapies, blood component transfusions and invasive monitoring were the most commonly modified/interrupted measures in case of futility. Almost 85% of respondents have not received training in palliative/supportive care. The proportion of respondents whose institution has a palliative care team and who had training in palliative care was not homogenous across the country. Conclusions: These data suggest that training in palliative care and its clinical application should be implemented in Italy. Efforts should be made to improve and homogenize the management of dying patients in ICU.
Lingua originaleEnglish
pagine (da-a)1-8
Numero di pagine8
RivistaSupportive Care in Cancer
Stato di pubblicazionePublished - 2018

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Palliative Care
Intensive Care Units
Medical Futility
Blood Component Transfusion
Thirst
Anesthesiology
Critical Care
Surveys and Questionnaires
Anesthesiologists
Critical Illness
Dyspnea
Analgesia
Italy
Consensus
Therapeutics
Pain

All Science Journal Classification (ASJC) codes

  • Oncology

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title = "Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey",
abstract = "Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36{\^a}45 years of age (34{\%}) and catholic (66{\%}). Almost 70{\%} of responders declared that palliative/supportive care are applied in their ICU in case of futility of intensive treatments. Decision on withdrawing/withholding of life-sustaining treatments resulted from team consensus in most cases (58{\%}). In more than 70{\%} of responders{\^a} ICUs, there is no collaboration with palliative/supportive care experts. Systematic recording of most frequent symptoms experienced by critically ill patients (e.g., pain, dyspnea, thirst) was not common. Vasopressors, extracorporeal therapies, blood component transfusions and invasive monitoring were the most commonly modified/interrupted measures in case of futility. Almost 85{\%} of respondents have not received training in palliative/supportive care. The proportion of respondents whose institution has a palliative care team and who had training in palliative care was not homogenous across the country. Conclusions: These data suggest that training in palliative care and its clinical application should be implemented in Italy. Efforts should be made to improve and homogenize the management of dying patients in ICU.",
keywords = "End-of-life care, Intensive care unit, Life-sustaining treatments, Oncology, Palliative care",
author = "Raineri, {Santi Maurizio} and Andrea Cortegiani and Antonino Giarratano and Cesare Gregoretti and Sebastiano Mercadante and Sebastiano Mercadante and Vincenzo Russotto",
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T1 - Attitudes towards end-of-life issues in intensive care unit among Italian anesthesiologists: a nation-wide survey

AU - Raineri, Santi Maurizio

AU - Cortegiani, Andrea

AU - Giarratano, Antonino

AU - Gregoretti, Cesare

AU - Mercadante, Sebastiano

AU - Mercadante, Sebastiano

AU - Russotto, Vincenzo

PY - 2018

Y1 - 2018

N2 - Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36â45 years of age (34%) and catholic (66%). Almost 70% of responders declared that palliative/supportive care are applied in their ICU in case of futility of intensive treatments. Decision on withdrawing/withholding of life-sustaining treatments resulted from team consensus in most cases (58%). In more than 70% of respondersâ ICUs, there is no collaboration with palliative/supportive care experts. Systematic recording of most frequent symptoms experienced by critically ill patients (e.g., pain, dyspnea, thirst) was not common. Vasopressors, extracorporeal therapies, blood component transfusions and invasive monitoring were the most commonly modified/interrupted measures in case of futility. Almost 85% of respondents have not received training in palliative/supportive care. The proportion of respondents whose institution has a palliative care team and who had training in palliative care was not homogenous across the country. Conclusions: These data suggest that training in palliative care and its clinical application should be implemented in Italy. Efforts should be made to improve and homogenize the management of dying patients in ICU.

AB - Background: The aim of this paper is to collect data on the practice of palliative care, withholding and withdrawal of life-sustaining therapies, and management of end of life (EOL) in Italian intensive care units (ICUs). Methods: Web-based survey among Italian anesthesiologists endorsed by the Italian Society of Anesthesiology Analgesia Reanimation and Intensive Care (SIAARTI). The survey consists of 27 close-ended and 2 open-ended questions. Results: Eight hundred and five persons responded to the full list of questions. The highest proportion of respondents was of 36â45 years of age (34%) and catholic (66%). Almost 70% of responders declared that palliative/supportive care are applied in their ICU in case of futility of intensive treatments. Decision on withdrawing/withholding of life-sustaining treatments resulted from team consensus in most cases (58%). In more than 70% of respondersâ ICUs, there is no collaboration with palliative/supportive care experts. Systematic recording of most frequent symptoms experienced by critically ill patients (e.g., pain, dyspnea, thirst) was not common. Vasopressors, extracorporeal therapies, blood component transfusions and invasive monitoring were the most commonly modified/interrupted measures in case of futility. Almost 85% of respondents have not received training in palliative/supportive care. The proportion of respondents whose institution has a palliative care team and who had training in palliative care was not homogenous across the country. Conclusions: These data suggest that training in palliative care and its clinical application should be implemented in Italy. Efforts should be made to improve and homogenize the management of dying patients in ICU.

KW - End-of-life care

KW - Intensive care unit

KW - Life-sustaining treatments

KW - Oncology

KW - Palliative care

UR - http://hdl.handle.net/10447/272592

M3 - Article

SP - 1

EP - 8

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

ER -