Technology, Palliative Care and ICU

Hola a tod@s, my dear friends.

Just published in American Journal of Respiratory and Critical Care Medicine, today we coment the article “Using Technology to Create a More Humanistic Approach to Integrating Palliative Care Into the Intensive Care Unit”, signed by Christopher E Cox and J. Randall Curtis, thanks to Drs. Vicente Gómez and Wesley Ely.

A decade ago, the main obstacles to the integration of Palliative Care in the ICU were the limited number of professionals trained, a little evidence and a poor assessment of the integration of this care in the ICU.

Nowadays, the development of Palliative Care has been exponential and has notably increased its application (fewer hospital stays with more satisfaction of all those involved, without changes in mortality), but even it´s estimated as suboptimal the application in ICU, and Palliative Care is an essential component of quality care. Perhaps there is enough references and the identification of patients is difficult.

Once again, the authors propose stopping to think: reviewing the strengths and limitations of the current system and propose to use the electronic medical record to include:

1. Detecting patients with poor prognosis, and early consultation with specialists in palliative.

2. Integrating patient- and family-reported needs.

3. Personalizing care.

4. Efficient classification of the family-patient unit to the appropriate level of care (intensivists, nurses, social workers or specialists in palliative care).

In the approaches considered, today’s challenges are described and the authors propose specific solutions through three strategies that use technology to improve the quality of human interaction in a complex and stressful environment.

They suggest as possible limitations the own historical resistance of the intensivists to the role of Palliative Care (become increasingly more changing); the lack of computerization of medical records which would help in the early detection and confirm that the tool itself will help to integrate everyone’s attention.

We have the hystoric opportunity for the integration of Palliative Care in the ICU, because we are becoming more aware of its importance.