Palliative Care for Patients on Mechanical Circulatory Support

Area of Science:

• Cardiology
• Palliative Care Medicine
• Medical Ethics

Background:

• Palliative care (PC) teams are increasingly involved in caring for patients with advanced illness requiring mechanical circulatory support (MCS).
• Existing guidelines for PC integration in MCS care are insufficient, despite stakeholder support for collaboration.
• PC's role spans decision-making, therapy duration, and end-of-life care for MCS patients.

Purpose of the Study:

• To highlight the critical need for enhanced palliative care integration in mechanical circulatory support (MCS) patient management.
• To identify key areas where PC teams can provide essential support throughout the MCS continuum.
• To underscore the importance of addressing barriers to effective PC-MCS collaboration.

Main Methods:

• Literature review and synthesis of current practices in palliative care and mechanical circulatory support.
• Analysis of stakeholder recommendations regarding interdisciplinary collaboration.
• Identification of PC interventions relevant to the MCS patient journey.

Main Results:

• Palliative care teams offer vital support in symptom management, advance care planning, and communication for MCS patients.
• Collaboration between PC and MCS teams is currently variable and faces challenges like staffing and clinician hesitancy.
• Effective PC engagement is crucial across all phases of MCS therapy, from initiation to end-of-life.

Conclusions:

• Meaningful palliative care engagement is essential for optimizing the care of patients with advanced cardiopulmonary life-sustaining therapies.
• Addressing barriers to collaboration will improve the comprehensive care of patients on mechanical circulatory support.
• Structured guidelines are needed to facilitate seamless integration of palliative care throughout the MCS patient experience.