Palliative Care in Severe Neurotrauma Patients in the Intensive Care Unit

Traumatic brain injury (TBI) is a significant cause of mortality and morbidity worldwide and many patients with TBI require intensive care unit (ICU) management. When facing a life-threatening illness, such as TBI, a palliative care approach that focuses on noncurative aspects of care should always...

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Bibliographic Details
Published in:Neurocritical care 2023-12, Vol.39 (3), p.557-564
Main Authors: Dolmans, Rianne G. F., Robertson, Faith C., Eijkholt, Marleen, van Vliet, Peter, Broekman, Marike L. D.
Format: Article
Language:English
Subjects:
Brain research
Critical care
Critical Care Medicine
Ethical Matters
Hospice care
Hospital costs
Intensive
Intensive care
Internal Medicine
Medicine
Medicine & Public Health
Mortality
Neurology
Neurosurgery
Pain
Palliative care
Patients
Symptom management
Trauma
Traumatic brain injury
Young adults
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Summary:Traumatic brain injury (TBI) is a significant cause of mortality and morbidity worldwide and many patients with TBI require intensive care unit (ICU) management. When facing a life-threatening illness, such as TBI, a palliative care approach that focuses on noncurative aspects of care should always be considered in the ICU. Research shows that neurosurgical patients in the ICU receive palliative care less frequently than the medical patients in the ICU, which is a missed opportunity for these patients. However, providing appropriate palliative care to neurotrauma patients in an ICU can be difficult, particularly for young adult patients. The patients’ prognoses are often unclear, the likelihood of advance directives is small, and the bereaved families must act as decision-makers. This article highlights the different aspects of the palliative care approach as well as barriers and challenges that accompany the TBI patient population, with a particular focus on young adult patients with TBI and the role of their family members. The article concludes with recommendations for physicians for effective and adequate communication to successfully implement the palliative care approach into standard ICU care and to improve quality of care for patients with TBI and their families.
ISSN:1541-6933
1556-0961
DOI:10.1007/s12028-023-01717-1