[Between intensive care and palliative care at the time of CoViD-19.]
Identifieur interne : 000018 ( Main/Merge ); précédent : 000017; suivant : 000019[Between intensive care and palliative care at the time of CoViD-19.]
Auteurs : Massimo RomanSource :
- Recenti progressi in medicina [ 2038-1840 ] ; 2020.
Descripteurs français
- KwdFr :
- Allocation des ressources, Capacité hospitalière, Deuil (perte), Humains, Indice de gravité médicale, Infections à coronavirus (), Infections à coronavirus (psychologie), Infections à coronavirus (épidémiologie), Italie, Pandémies, Pneumopathie virale (), Pneumopathie virale (psychologie), Pneumopathie virale (épidémiologie), Prise de décision, Ressources en santé, Santé de la famille, Soins de réanimation (éthique), Soins palliatifs (éthique), Ventilation artificielle, Équité en santé.
- MESH :
- psychologie : Infections à coronavirus, Pneumopathie virale.
- épidémiologie : Infections à coronavirus, Pneumopathie virale.
- éthique : Soins de réanimation, Soins palliatifs.
- Allocation des ressources, Capacité hospitalière, Deuil (perte), Humains, Indice de gravité médicale, Infections à coronavirus, Italie, Pandémies, Pneumopathie virale, Prise de décision, Ressources en santé, Santé de la famille, Ventilation artificielle, Équité en santé.
- Wicri :
- geographic : Italie.
English descriptors
- KwdEn :
- Bereavement, Betacoronavirus, Coronavirus Infections (epidemiology), Coronavirus Infections (psychology), Coronavirus Infections (therapy), Critical Care (ethics), Decision Making, Family Health, Health Equity, Health Resources, Hospital Bed Capacity, Humans, Italy, Palliative Care (ethics), Pandemics, Pneumonia, Viral (epidemiology), Pneumonia, Viral (psychology), Pneumonia, Viral (therapy), Resource Allocation, Respiration, Artificial, Severity of Illness Index.
- MESH :
- geographic : Italy.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- ethics : Critical Care, Palliative Care.
- psychology : Coronavirus Infections, Pneumonia, Viral.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- Bereavement, Betacoronavirus, Decision Making, Family Health, Health Equity, Health Resources, Hospital Bed Capacity, Humans, Pandemics, Resource Allocation, Respiration, Artificial, Severity of Illness Index.
Abstract
The pandemic infection caused by the virus SARS-CoV-2 has determined a severe imbalance between demand and actual supply of intensive care. The shortage of intensive care units (ICU) beds and ventilators for the treatment of patients with severe respiratory failure produced angst in the clinicians/intensivists who have to decide which patients admit to ICU and in which patients to implement palliative care. They have to apply specific clinical and ethical criteria, in emergency conditions. Proportionality and appropriateness criteria should be integrated with equity, equality, utility criteria, widening the distributive justice concept from the right of the patient to receive all available therapies to a right resources allocation during shortage, guided by public health ethic. The clinical criteria should include the disease severity, the number and severity of comorbidities, frailty, the organ failures and their stage, the patient's age, the functional autonomy and cognitive status. Consequently the first come-first served rule to ICU admission should not be applied. The patients not admitted to ICU due to clinical reasons and advanced stage diseases should receive a high quality palliative care, to obtain a good symptoms control (mainly dyspnea, anxiety and delirium) and to implement palliative sedation at the end of life. Finally particular attention should be paid to the bereavement management of the family/caregivers and in the right approach of psychological problems and Post-Traumatic Stress Disorder of health workers involved in the pandemia.
DOI: 10.1701/3347.33185
PubMed: 32319444
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: 000045
- to stream PubMed, to step Curation: 000045
- to stream PubMed, to step Checkpoint: 000012
- to stream Ncbi, to step Merge: 000F65
- to stream Ncbi, to step Curation: 000F65
- to stream Ncbi, to step Checkpoint: 000F65
Links to Exploration step
pubmed:32319444Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">[Between intensive care and palliative care at the time of CoViD-19.]</title><author><name sortKey="Roman, Massimo" sort="Roman, Massimo" uniqKey="Roman M" first="Massimo" last="Roman">Massimo Roman</name><affiliation><nlm:affiliation>Cardiologo, Comitato Ordinatore Master di 2° livello in Cure Palliative, Università di Milano.</nlm:affiliation><wicri:noCountry code="subField">Università di Milano</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32319444</idno><idno type="pmid">32319444</idno><idno type="doi">10.1701/3347.33185</idno><idno type="wicri:Area/PubMed/Corpus">000045</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000045</idno><idno type="wicri:Area/PubMed/Curation">000045</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000045</idno><idno type="wicri:Area/PubMed/Checkpoint">000012</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000012</idno><idno type="wicri:Area/Ncbi/Merge">000F65</idno><idno type="wicri:Area/Ncbi/Curation">000F65</idno><idno type="wicri:Area/Ncbi/Checkpoint">000F65</idno><idno type="wicri:Area/Main/Merge">000018</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Between intensive care and palliative care at the time of CoViD-19.]</title><author><name sortKey="Roman, Massimo" sort="Roman, Massimo" uniqKey="Roman M" first="Massimo" last="Roman">Massimo Roman</name><affiliation><nlm:affiliation>Cardiologo, Comitato Ordinatore Master di 2° livello in Cure Palliative, Università di Milano.</nlm:affiliation><wicri:noCountry code="subField">Università di Milano</wicri:noCountry></affiliation></author></analytic><series><title level="j">Recenti progressi in medicina</title><idno type="eISSN">2038-1840</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Bereavement</term><term>Betacoronavirus</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (psychology)</term><term>Coronavirus Infections (therapy)</term><term>Critical Care (ethics)</term><term>Decision Making</term><term>Family Health</term><term>Health Equity</term><term>Health Resources</term><term>Hospital Bed Capacity</term><term>Humans</term><term>Italy</term><term>Palliative Care (ethics)</term><term>Pandemics</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (psychology)</term><term>Pneumonia, Viral (therapy)</term><term>Resource Allocation</term><term>Respiration, Artificial</term><term>Severity of Illness Index</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Allocation des ressources</term><term>Capacité hospitalière</term><term>Deuil (perte)</term><term>Humains</term><term>Indice de gravité médicale</term><term>Infections à coronavirus ()</term><term>Infections à coronavirus (psychologie)</term><term>Infections à coronavirus (épidémiologie)</term><term>Italie</term><term>Pandémies</term><term>Pneumopathie virale ()</term><term>Pneumopathie virale (psychologie)</term><term>Pneumopathie virale (épidémiologie)</term><term>Prise de décision</term><term>Ressources en santé</term><term>Santé de la famille</term><term>Soins de réanimation (éthique)</term><term>Soins palliatifs (éthique)</term><term>Ventilation artificielle</term><term>Équité en santé</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Italy</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="ethics" xml:lang="en"><term>Critical Care</term><term>Palliative Care</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="éthique" xml:lang="fr"><term>Soins de réanimation</term><term>Soins palliatifs</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Bereavement</term><term>Betacoronavirus</term><term>Decision Making</term><term>Family Health</term><term>Health Equity</term><term>Health Resources</term><term>Hospital Bed Capacity</term><term>Humans</term><term>Pandemics</term><term>Resource Allocation</term><term>Respiration, Artificial</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Allocation des ressources</term><term>Capacité hospitalière</term><term>Deuil (perte)</term><term>Humains</term><term>Indice de gravité médicale</term><term>Infections à coronavirus</term><term>Italie</term><term>Pandémies</term><term>Pneumopathie virale</term><term>Prise de décision</term><term>Ressources en santé</term><term>Santé de la famille</term><term>Ventilation artificielle</term><term>Équité en santé</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Italie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The pandemic infection caused by the virus SARS-CoV-2 has determined a severe imbalance between demand and actual supply of intensive care. The shortage of intensive care units (ICU) beds and ventilators for the treatment of patients with severe respiratory failure produced angst in the clinicians/intensivists who have to decide which patients admit to ICU and in which patients to implement palliative care. They have to apply specific clinical and ethical criteria, in emergency conditions. Proportionality and appropriateness criteria should be integrated with equity, equality, utility criteria, widening the distributive justice concept from the right of the patient to receive all available therapies to a right resources allocation during shortage, guided by public health ethic. The clinical criteria should include the disease severity, the number and severity of comorbidities, frailty, the organ failures and their stage, the patient's age, the functional autonomy and cognitive status. Consequently the first come-first served rule to ICU admission should not be applied. The patients not admitted to ICU due to clinical reasons and advanced stage diseases should receive a high quality palliative care, to obtain a good symptoms control (mainly dyspnea, anxiety and delirium) and to implement palliative sedation at the end of life. Finally particular attention should be paid to the bereavement management of the family/caregivers and in the right approach of psychological problems and Post-Traumatic Stress Disorder of health workers involved in the pandemia.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/StressCovidV1/Data/Main/Merge
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000018 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Merge/biblio.hfd -nk 000018 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= StressCovidV1
|flux= Main
|étape= Merge
|type= RBID
|clé= pubmed:32319444
|texte= [Between intensive care and palliative care at the time of CoViD-19.]
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Merge/RBID.i -Sk "pubmed:32319444" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Merge/biblio.hfd \
| NlmPubMed2Wicri -a StressCovidV1
| This area was generated with Dilib version V0.6.33. |  |