End-of-Life Care for Critically Ill Patients with Heart Failure: A Multidisciplinary Viewpoint from the Intensive Care Unit

Abstract

Care near the end of life (EOL) for critically ill patients is emerging as an essential task in cardiology and heart failure (HF) management. Professional recommendations were recently published on this topic and a consensus exists that research and debate in this area need further progress. In the field of critical care medicine, development of research about EOL care was substantial during the last decade. The growing incidence of decisions to forgo life-sustaining therapies (DFLSTs) stimulated ethical debates and led to official statements of European and American intensive care medicine societies. This chapter discusses the interdisciplinary aspects of EOL care by reviewing the critical care medicine literature concerning EOL care in the intensive care unit (ICU), for the benefit of physicians involved in EOL care for critically ill patients with HF. First, EOL decisions in the ICU, their incidence, and the legal/ethical background of the decision-making process leading to DFLSTs are reviewed, with comparison with data available about patients with HF.