Palliative Medicine Consultation for Preparedness Planning in Patients Receiving Left Ventricular Assist Devices as Destination Therapy
Palliative Medicine Consultation for Preparedness Planning in Patients Receiving Left Ventricular Assist Devices as Destination Therapy
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DOI：
10.4065/mcp.2010.0747
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发表时间：
2011-06-01
影响因子：
8.9
通讯作者：
Mueller, Paul S.
中科院分区：
文献类型：
--
作者：
Swetz, Keith M.;Freeman, Monica R.;Mueller, Paul S.
目的：为了评估积极的姑息医学咨询的好处，描绘目标的护理和生活质量的偏好前植入左心室辅助装置作为目标治疗（DT）患者和方法：我们回顾性审查的情况下，谁接受DT 2009年1月15日至2010年1月1日。结果：在确定的19例患者中，13例（68%）接受了积极的姑息医学咨询。姑息性药物咨询的中位时间为DT植入前1天（范围，植入前5天至植入后16天）。13名患者（68%）完成了预先指令。DT植入团队和家属报告称，植入前讨论和护理计划的目标使术后护理更加明确，不良事件得到更有效的处理。目前，姑息医学参与患者接受DT被视为常规的心脏护理experts.CONCLUSION：积极主动的姑息医学咨询患者正在考虑或正在治疗DT提高了提前护理计划，从而有助于更好地整体护理这些患者。我们的经验突出了集中的提前护理计划，全面探索护理目标，以及专家症状管理和适当的临终关怀。
OBJECTIVE: To assess the benefit of proactive palliative medicine consultation for delineation of goals of care and quality-of-life preferences before implantation of left ventricular assist devices as destination therapy (DT).PATIENTS AND METHODS: We retrospectively reviewed the cases of patients who received DT between January 15, 2009, and January 1, 2010.RESULTS: Of 19 patients identified, 13 (68%) received proactive palliative medicine consultation. Median time of palliative medicine consultation was 1 day before DT implantation (range, 5 days before to 16 days after). Thirteen patients (68%) completed advance directives. The DT implantation team and families reported that preimplantation discussions and goals of care planning made postoperative care more clear and that adverse events were handled more effectively. Currently, palliative medicine involvement in patients receiving DT is viewed as routine by cardiac care specialists.CONCLUSION: Proactive palliative medicine consultation for patients being considered for or being treated with DT improves advance care planning and thus contributes to better overall care of these patients. Our experience highlights focused advance care planning, thorough exploration of goals of care, and expert symptom management and end-of-life care when appropriate.