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Critical Care: Critical Care Nonpulmonary |

Alleviation of Sufferings for Resuscitated Comatose OHCA (ROSC) Patients and Their Family by Hospice Care FREE TO VIEW

Tsung-Po Tsai, PhD; An-Hua Sun, MBA; Su-Chin Tsao, NP; Heng Su, MD; Shih-Chen Tsai, MD
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Chung Shan Medical University Hospital, Taichung, Taiwan


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(4_S):A173. doi:10.1016/j.chest.2016.02.179
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SESSION TITLE: Critical Care Nonpulmonary

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Palliative and spiritual care for comatose survivors of out-of hospital cardiac arrest (OHCA) is valuable and untapped resource for support and alleviation of suffering of both patients and their family members. We reviewed those cases retrospectively and assured the value of palliative care in patients with nearly medical futility.

METHODS: 170 (including 23 traumatic) out of 705 OHCA patients were successfully resuscitated (return of spontaneous circulation ROSC) at ER of CSMUH (from Jan 1st, 2011 to Apr 30, 2014). Only 33 (M: F = 25: 8) out of 147 medically resuscitated OHCA patients with one or more cardiac risk factors were transferred for emergency cardiac catheterization (33/147). 31 underwent percutaneous coronary intervention (PCI) procedure, one underwent coronary artery bypass grafting (CABG) and one underwent aortic valvular replacement (AVR). 8 patients (8/33=24.2 %) were survived to hospital discharge. However, 25 survived patients were in comatose state at ICU. Among them, 2 were transferred to respiratory care ward (RCW) and 24 eventually deceased after palliative and spiritual care. Another 6 OHCA patients required extracorporeal membrane oxygenation (ECMO) support but only one underwent PCI survived. We applied palliative and spiritual care for these 25 patients with nearly medical futility.

RESULTS: Spiritual care is good for all those survived to hospital discharge (8 patients) and were followed at OPD periodically (6-43 mos, mean 30.4 m) without post-traumatic stress syndrome and depression. Palliative and spiritual care for those consistent comatose OHCA survivors achieve alleviation of suffering of both patients and their family member. It also decreased the delays in care to other critical patients at ICU.

CONCLUSIONS: Palliative and spiritual care for resuscitated comatose OHCA patients can alleviate the suffering of both patients and their family members. It also decreased the delays in care to other critically ill patients at ICU.

CLINICAL IMPLICATIONS: Palliative and spiritual care for resuscitated comatose OHCA patients can alleviate the suffering of both patients and their family members.

DISCLOSURE: The following authors have nothing to disclose: Tsung-Po Tsai, An-Hua Sun, Su-Chin Tsao, Heng Su, Shih-Chen Tsai

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