[Comfort Terminal Care in the intensive care unit: recommendations for practice]

Area of Science:

• Anesthesiology and Intensive Care Medicine
• Palliative Care
• Medical Ethics

Context:

• Follow-up paper addressing practical implementation challenges of Comfort Terminal Care.
• Builds upon previous documentation tools developed by the Austrian Society for Anesthesiology Resuscitation and Intensive Care Medicine (ÖGARI).
• Addresses numerous questions arising from daily clinical practice.

Purpose:

• To provide evidence-based answers to practical questions regarding Comfort Terminal Care.
• To detail the implementation of pain therapy and reduction of anxiety, stress, and respiratory distress.
• To clarify indicated and non-indicated interventions, including monitoring, laboratory findings, drug treatment, and nursing actions.

Summary:

• Discusses the practical application of Comfort Terminal Care, including pain management and reduction of psychological distress.
• Clarifies which interventions are indicated (e.g., symptom control) and not indicated (e.g., ventilation, excessive fluids) in this context.
• Provides recommendations on monitoring, drug therapy, nursing care, support for relatives, and post-mortem procedures.

Impact:

• Facilitates good and humane end-of-life care for seriously ill patients and their relatives.
• Enables patients to experience appreciation and positive moments until the end of life.
• Promotes ethical decision-making in adapting therapeutic goals towards the end of life.