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Palliative Care for Patients on Mechanical Circulatory Support
Sara E Wordingham1, Colleen K McIlvennan2
1A consultant with the Center for Palliative Medicine and an assistant professor of medicine in the College of Medicine and Science at the Mayo Clinic in Phoenix, Arizona, where she is also the vice-chair of the Ethics Subcommittee and a member of the Cardiac Transplantation Selection Committee.
Abstract:
Palliative care (PC) teams are primed to support patients with advanced illness, including patients with mechanical circulatory support (MCS), and are increasingly being called upon to help care for these patients. Detailed guidelines for PC engagement are lacking despite key stakeholders' endorsements of collaboration. PC should encompass the decision-making period, the duration of therapy, and end-of-life care. PC teams can assist with symptom management, advance care planning, and communication across the continuum of MCS care. However, the current state of MCS and PC collaboration is variable and can be hindered by staffing challenges and clinician discomfort. To best care for patients who receive advanced cardiopulmonary life-sustaining therapies, meaningful engagement of PC during all phases of MCS is essential.
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