Palliative Care in the ICU

Completed · Not applicable

Conditions studied: Palliative Care

In brief

The study compares early palliative care consultation to standard of care in the medical intensive care unit (ICU). The study will assess if the intervention leads to an increased proportion of clearly delineated goals of care and examine if this intervention leads to decreased healthcare resource utilization such as length of stay, duration of intensive treatments including mechanical ventilation, and hospital re-admissions.

Key facts

Study ID

NCT03263143

Run by

Washington University School of Medicine

People needed

242

Starts

2017-08-07

Expected to finish

2018-11-30

Last updated by the study team

2019-01-24

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Admitted to the ICU in the last 24 hours
• Admitted from Skilled nursing facility (SNF), long term acute care (LTAC)facility, long term ventilator care (vent LTC) unit, or home care with private duty nursing with activity of daily living (ADL) dependencies
• End-stage dementia, amyotrophic lateral sclerosis, Parkinson's, multiple sclerosis
• Advanced or Metastatic Cancer
• Cardiac or respiratory arrest with neurological compromise
• Multi- organ system failure (more than 2 organ failures)
• Known diagnosis of end stage organ disease including cirrhosis, end-stage renal disease, congestive heart failure New York Heart Association >III, chronic obstructive pulmonary disease on home O2
• Shock requiring > 6 hours of vasopressors or inotropes
• Acute Respiratory failure requiring intubation or BiPAP
• Admitted to ICU with hospital length of stay of more than 5 days or ICU readmission with the same diagnosis in 30 days.

You may not qualify if…

• All stem cell transplant patients, for solid organ transplant, if undergoing evaluation for solid organ transplant or within 1 year post-transplant.
• Patients who do not speak English if interpreter is unavailable
• Patients without capacity to participate in palliative care discussions without a surrogate available
• Patients or patient surrogate refusal of palliative care consultation
• Prior Palliative Care Consultation during the same hospitalization
• For purposes of primary outcome analysis, patients determined to already be DNR/DNI at time of ICU admission

Where it is running

• Barnes Jewish Hospital — St Louis, Missouri, United States

Full record on ClinicalTrials.gov

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