{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:33Z","timestamp":1792787733791,"version":"4.5.0"},"reference-count":60,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute of General Medical Sciences","award":["5T32GM148369"],"award-info":[{"award-number":["5T32GM148369"]}],"id":[{"id":"https:\/\/ror.org\/04q48ey07","id-type":"ROR","asserted-by":"crossref"}]},{"name":"National Heart, Lung, and Blood Institute","award":["T32HL098054"],"award-info":[{"award-number":["T32HL098054"]}],"id":[{"id":"https:\/\/ror.org\/012pb6c26","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"abstract":"<jats:p>Cardiovascular disease (CVD) remains the leading cause of death worldwide and is a major driver of critical illness, resulting in admission to cardiac intensive care units (CICUs). Patients with acute, life-threatening CVD often experience episodes of acute decompensation characterized by high symptom burden that may portend progressive loss of function, significantly impair quality of life (QOL), and involve high-intensity, technologically advanced therapies to sustain life. Despite these advances, up to 30% of patients die during CICU hospitalizations, and those who survive may subsequently face persistent functional impairment and psychosocial distress. During critical CVD (CCVD), patients often endure prognostic uncertainty and face complex decisions regarding life-sustaining therapies alongside refractory symptoms. Thus, care that focuses exclusively on disease-directed or life-prolonging therapies is often insufficient to address the full spectrum of patient and caregiver needs. When integrated alongside intensive cardiovascular care, palliative care (PC) offers a complementary and essential approach to the management of CCVD to inform therapeutic decisions, improve QOL, and address psychosocial and spiritual well-being. In this article, a multidisciplinary team featuring PC clinicians (physicians, nurse practitioners, social worker, psychologist, and chaplain), cardiologists, cardiac surgeons, cardiothoracic anesthesiologists, and intensivists present evidence-based guidance in a \u201cTop Ten Tips\u201d format to support PC clinicians caring for CICU patients and their caregivers.<\/jats:p>","DOI":"10.1177\/10966218261496677","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T02:50:02Z","timestamp":1791427802000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Top Ten Tips Palliative Care Clinicians Should Know About Caring for People Receiving Critical Care for Cardiovascular Disease"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4717-3374","authenticated-orcid":false,"given":"Anne","family":"Song","sequence":"first","affiliation":[{"name":"Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA."},{"name":"Palliative and Advanced Illness Research (PAIR) Center at the University of Pennsylvania, Philadelphia, Pennsylvania, USA."},{"name":"Leonard Davis Institute of Health Economics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelli L.","family":"Feder","sequence":"additional","affiliation":[{"name":"Yale School of Nursing, West Haven, Connecticut, USA."},{"name":"Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Elmadhoun","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7049-0151","authenticated-orcid":false,"given":"Ankita","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie P.","family":"Wladkowski","sequence":"additional","affiliation":[{"name":"College of Health and Human Services, Bowling Green State University, Bowling Green, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald R.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Oregon Health &amp; Science University, Portland, Oregon, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Creel-Bulos","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Emory University School of Medicine, Atlanta, Georgia, USA."},{"name":"Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison J.","family":"Applebaum","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8864-1328","authenticated-orcid":false,"given":"Sarah E.","family":"Byrne-Martelli","sequence":"additional","affiliation":[{"name":"Department of Supportive Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Center for Palliative Care, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2903-092X","authenticated-orcid":false,"given":"Justyna","family":"Swol","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Paracelsus Medical University, Nuremberg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Lorusso","sequence":"additional","affiliation":[{"name":"Cardio-Thoracic Surgery Department, Maastricht University Medical Centre, Maastricht, The Netherlands."},{"name":"Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Cardiology and Leipzig Heart Institute, Heart Center Leipzig at University of Leipzig, Leipzig, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Vandenbriele","sequence":"additional","affiliation":[{"name":"Heart Center Aalst, Azorg Hospital, Aalst, Belgium."},{"name":"Cardiac Intensive Care, Harefield Hospital, Guy\u2019s &amp; St Thomas\u2019 NHS Foundation Trust, London, United Kingdom."},{"name":"Department of Surgery and Cancer, Faculty of Medicine, Imperial College, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah J.","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA."},{"name":"Department of Internal Medicine\/Community Internal Medicine, Geriatrics, and Palliative Care, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason N.","family":"Batten","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and 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