Palliative and End-of-Life Care During Critical Cardiovascular Illness: A Scientific Statement From the American Heart Association
Erin A. Bohula, Michael J. Landzberg, Venu Menon, Carlos L. Alviar, Gregory W. Barsness, Daniela R. Crousillat, Nelia Jain, Robert L. Page, Rachel Wells, Abdulla A. Damluji
Abstract
Cardiac intensive care units are witnessing a demographic shift, characterized by patients with increasingly complex or end-stage cardiovascular disease with a greater burden of concomitant comorbid noncardiovascular disease. Despite technical advances in care that may be offered, many critically ill cardiovascular patients will nevertheless experience significant morbidity and mortality during the acute decompensation, including physical and psychological suffering. Palliative care, with its specialized focus on alleviating suffering, aligns treatments with patient and caregiver values and improves overall care planning. Integrating palliative care into cardiovascular disease management extends the therapeutic approach beyond life-sustaining measures to encompass life-enhancing goals, addressing the physical, emotional, psychosocial, and spiritual needs of critically ill patients. This American Heart Association scientific statement aims to explore the definitions and conceptual framework of palliative care and to suggest strategies to integrate palliative care principles into the management of patients with critical cardiovascular illness.