"Improving the quality of care received by critically ill and dying patients in the ICU remains an ongoing challenge," explains guest co-editor J. Randall Curtis, M.D., M.P.H., professor of medicine at the University of Washington in Seattle. "Over the past five years there have been encouraging signs of improvement in end-of-life care in the ICU. Interventions have been developed, evaluated, and published to improve the care that patients and their families receive relating to the end of life in the ICU."
Approximately one in five deaths in the United States now occurs in the ICU or shortly after receiving intensive care. The ICU is likely to remain an important setting for end-of-life care because of the severity of illness in these patients and because many families and patients with chronic, life-limiting diseases will opt for a trial of intensive care.
Critical care researchers are taking the lessons learned from previous observational studies and using them to develop and test generalizable interventions that improve the quality of ICU end-of-life care. The Critical Care Medicine supplement includes 20 articles evaluating end-of-life issues, including palliative care in the ICU, attitudes toward withholding and withdrawing life support, ethical and legal issues, quality indicators, communications between physicians and nurses, interventions for children at the end of life, and promising future directions.
"We believe this supplement documents the tremendous progress that has been made in the past decade and represents the state of the art for assessing and improving end-of-life care in the ICU," comments gue