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Palliative Care Post Cardiac Surgery

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Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery

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Abstract

Palliative care aims to improve the quality of life for patients and their families facing problems associated with life-threatening illness. It strives to reduce distress associated with their illness through the early identification, assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual (Braun et al. Circulation 134(11):e198–e225, 2016; Palliative care: World Health Organization, 2017). Traditional palliative care is counter-culture to cardiac care. Surgical cardiac care health systems shy from accepting death as a potential appropriate outcome to a trial of cardiac surgery and palliative care teams shy from providing support to ameliorate symptoms for patients striving for survival in a post cardiac surgery (Schulz and Novick, Semin Cardiothorac Vasc Anesth 17:240–248, 2013). Palliative care and cardiac care programs are not yet aligned for a seamless integration of care. Fortunately, collaboration between palliative care and cardiac care teams is strengthening. This collaboration is driven in part by decisive policy statements and guidelines (Braun et al. Circulation 134(11):e198–e225, 2016; Ventricular Assist Devices (NCD 20.9.1). United Healthcare; 2016 October 12) and palliative care literature (see references in this chapter), that call for the integration of palliative care within cardiac care. Integration of palliative care and cardiac care is evolving. This chapter discusses the advancing role of palliative care support within the cardiac care team. Through the lens of a composite case vignette, we will discuss patient needs such as symptoms, communication and decision-making, as well as system opportunities and barriers to integrating palliative care on the cardiac care team.

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Acknowledgements

The academic support by the Department of Anesthesia and Perioperative Medicine, and Clinical Neurological Sciences, Western University.

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Authors and Affiliations

  1. Department of Anesthesia and Perioperative Medicine, Western University, London, ON, Canada

    Valerie Schulz

  2. Department of Clinical Neurological Sciences, Western University, London, ON, Canada

    Teneille Gofton

Authors
  1. Valerie Schulz
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  2. Teneille Gofton
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Corresponding author

Correspondence to Valerie Schulz .

Editor information

Editors and Affiliations

  1. Distinguished University Professor Department of Anesthesia and Perioperative Medicine and Department of MedicineDivision of Critical Care Medicine, London Health Sciences Center and St Joseph’s Healthcare London Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) Western University, London, ON, Canada

    Davy C.H. Cheng

  2. Associate Professor Department of Anesthesia and Perioperative Medicine and Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) Western University, London, ON, Canada

    Janet Martin

  3. Professor of Surgery University of Toronto, Melanie Munk Chair of Cardiovascular Surgery University Health Network, Toronto, ON, Canada

    Tirone David

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Schulz, V., Gofton, T. (2021). Palliative Care Post Cardiac Surgery. In: Cheng, D.C., Martin, J., David, T. (eds) Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-47887-2_58

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  • DOI: https://doi.org/10.1007/978-3-030-47887-2_58

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-47886-5

  • Online ISBN: 978-3-030-47887-2

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