Palliative care in the cardiovascular intensive care unit: A systematic review of current literature

Area of Science:

• Cardiology
• Palliative Care
• Intensive Care Medicine

Background:

• Patient acuity and complexity in Cardiac Intensive Care Units (CICUs) have increased.
• Current data on palliative care integration within contemporary CICU practice remain scarce.

Approach:

• A systematic literature review was conducted across major databases (PubMed Central, CINAHL, EMBASE, Medline, Cochrane Library, Scopus, Web of Science).
• Studies published between 2000 and 2022 focusing on adult patients admitted to CICUs with acute cardiovascular conditions were included.
• The primary outcome was the utilization of palliative care services; secondary outcomes were also assessed. Meta-analysis was not feasible due to study heterogeneity.

Key Points:

• 30 studies met inclusion criteria, all published within the last seven years, predominantly from the United States.
• Heart failure was the most common diagnosis (47%), and in-hospital mortality was reported in 67% of studies.
• Significant heterogeneity was observed in palliative care consultation timing, frequency, and provider background. Two randomized trials suggested improved quality of life without affecting mortality.

Conclusions:

• Despite increasing acknowledgment of palliative care's value, robust data on its consultation within CICUs are limited.
• Further research is needed to understand and optimize palliative care delivery in this critical care setting.