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ESICM consensus-based recommendations for the management of very old patients in intensive care
M. Beil, L. Alberto, RS. Bourne, NE. Brummel, B. de Groot, DW. de Lange, P. Elbers, M. Emmelot-Vonk, H. Flaatten, Y. Freund, A. Galazzi, A. Garcia-Martinez, B. Guidet, I. Holmerova, JM. Jacobs, GM. Joynt, S. Leaver, M. Leone, B. McNicholas, D....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
- MeSH
- delfská metoda * MeSH
- geriatrie metody normy MeSH
- konsensus * MeSH
- kritický stav terapie MeSH
- lidé MeSH
- medicína založená na důkazech normy metody MeSH
- péče o pacienty v kritickém stavu * normy metody MeSH
- senioři nad 80 let MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
PURPOSE: The heterogeneity of very old patients (age ≥ 80 years) and the prevalence of complex geriatric syndromes in this cohort constitute major challenges for the classical methods of evidence-based medicine to inform clinical practice. The lack of robust guidance for the management of critical conditions in these patients contributes to considerable uncertainty among practitioners and unwarranted variations of care. The European Society of Intensive Care Medicine (ESICM) initiated a Delphi study to translate the empirical knowledge of experts in this field into consensus-based recommendations for clinical practice. METHODS: A multi-national group of specialists in intensive care, emergency, and geriatric medicine provided opinions on managing very old patients with critical conditions. Strong or moderate consensus was defined as having at least 90% or 80% of experts, respectively, expressing agreement or disagreement on the three highest or lowest levels of a 9-points Likert scale. RESULTS: Twenty-eight members of the expert steering group and 82 additional experts completed two Delphi rounds. After discussing the results, the steering group issued recommendations for 48 statements and 2 checklists for which consensus was achieved. In addition to determining fundamental principles, they include advice on goals of care and the decision-making about admission to and treatment of patients in intensive care and the management after discharge. CONCLUSION: A multi-disciplinary group of experts achieved consensus on recommendations concerning intensive care for very old patients, which were approved and endorsed by ESICM. The implementation requires a careful analysis of available healthcare resources and should proceed in a stepwise fashion.
Centre for Care Excellence Coventry University Coventry UK
Centre for Education Faculty of Life Sciences and Medicine King's College London UK
Centre for Urgent and Emergency Care Research University of Sheffield Sheffield UK
Consejo Nacional de Investigaciones Científicas y Técnicas Ciudad de Buenos Aires Argentina
Department of Anaesthesia and Intensive Care Medicine Galway University Hospital Galway Ireland
Department of Critical Care King's College Hospital NHS Foundation Trust London UK
Department of Emergency Medicine Radboud UMC Nijmegen The Netherlands
Department of Geriatrics University Medical Center Utrecht Utrecht The Netherlands
Department of Intensive Care Medicine University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Medicine NHS Highland Inverness UK
Department of Medicine University of Udine Udine Italy
Department of Population Health Sciences University of Leicester Leicester UK
Department of Research and Development Haukeland University Hospital Bergen Norway
Emergency Department Hospital Clínic IDIBAPS Barcelona Spain
Emergency Department University Hospital University of Basel Basel Switzerland
National Institute for Health and Care Research Oxford Road Manchester UK
Operative Unit of Pain Therapy S Martino Hospital Belluno Italy
Research Centre for Emergency Medicine Aarhus University Hospital Aarhus Denmark
Citace poskytuje Crossref.org
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