Status:
COMPLETED
Palliative Care in the ICU
Lead Sponsor:
Washington University School of Medicine
Conditions:
Palliative Care
Eligibility:
All Genders
18+ years
Phase:
NA
Brief Summary
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 clearl...
Detailed Description
* The medical intensive care unit will be split into two groups, assigned as either early palliative care consultation or standard of care. Current standard of care in the ICU is that primary clinicia...
Eligibility Criteria
Inclusion
- 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.
Exclusion
- 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
Key Trial Info
Start Date :
August 7 2017
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
November 30 2018
Estimated Enrollment :
242 Patients enrolled
Trial Details
Trial ID
NCT03263143
Start Date
August 7 2017
End Date
November 30 2018
Last Update
January 24 2019
Active Locations (1)
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1
Barnes Jewish Hospital
St Louis, Missouri, United States, 63110