Advanced technology has made prolonged life support possible, yet approximately 22% of deaths of adult patients in the United States occur in intensive care units (ICUs). Successful transition from active treatment to end-of-life (EOL) care requires good communication and shared decision-making. However, conflict and poor interdisciplinary collaboration among health care professionals reduces the quality of EOL care and contributes to family distress.Brooks and colleagues conducted focus group interviews with ICU nurses and physicians to discuss their experiences and perceptions of EOL care. They found the following:The authors recommend staff support and education from senior clinicians to improve interdisciplinary EOL care. Clear organizational processes with a collaborative decision-making framework can assist staff in leadership roles.See Article, pp 336–341Sleep disruption is a well-known problem for patients in intensive care units (ICUs). Poor-quality sleep that is short contributes to poor outcomes such as delirium and posthospital syndrome. Little is known about the perceptions of patients and clinical staff regarding environmental and nonenvironmental factors affecting patients’ sleep.Ding and colleagues explored the perceptions of adult patients in a medical ICU, patients’ surrogates, and night-shift clinical staff, including nurses, physicians, patient-care assistants, and respiratory therapists. They identified 4 themes:The authors recommend interventions to include an assessment of patients’ psychological stress and perceptions of stress-reduction strategies.See Article, pp 278–286Sedative medications are used to reduce anxiety and increase relaxation in ICU patients receiving mechanical ventilation (MV). Patient-controlled analgesia has been used successfully to manage pain in MV patients, but whether the same principles can be applied to sedative therapy is unknown.Chlan and colleagues conducted a small study in 2010 that showed that MV patients were willing and able to manage their anxiety through self-administered sedatives in a 24-hour period. In this randomized study, they evaluated the use of self-administered dexmedetomidine for up to 5 days with adult MV patients. They found the following:The results show that self-administered sedation therapy was a safe intervention with select patients.See Article, pp 288–296Extracorporeal membrane oxygenation (ECMO) is often used to treat cardiogenic shock and lung failure and as a bridge to lung transplant. Evidence suggests that outcomes after hospital discharge include cognitive impairment, depression, and anxiety, but long-term implications are unknown.Tramm and colleagues examined physical and mental health outcomes in adult patients during the year after ECMO therapy. They found the following:Given the number of patients with lower-extremity issues, the authors suggest including the EuroQol-5-Dimensions-5-Levels tool as a core outcome measure of mobility to detect neurological problems during hospitalization.See Article, pp 311–319