{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:14:26Z","timestamp":1790810066866,"version":"4.1.0"},"reference-count":5,"publisher":"AACN Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Recent data indicate that end-of-life management for patients affected by acute decompensated heart failure in cardiac intensive care units is aggressive, with late or no engagement of palliative care teams.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess current palliative care and end-of-life practices in a contemporary Italian multicenter registry of patients with cardiogenic shock due to acute decompensated heart failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A survey-based approach was used to collect data on palliative care and end-of-life management practices. The AltShock-2 registry enrolled patients with cardiogenic shock from 12 participating centers. A subset of 153 patients with cardiogenic shock due to acute decompensated heart failure enrolled between March 2020 and March 2023 was analyzed, with a focus on early engagement of palliative care teams and deactivation of implantable cardioverter-defibrillators (ICDs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\u201cDo not resuscitate\u201d orders were documented in patient records in only 5 of 12 centers (42%). Palliative care teams were engaged for 21 of 153 enrolled patients (13.7%). Among the 51 patients with ICDs, 6 of 17 patients who died (35%) had defibrillator deactivation. Of the 17 patients who died, 13 died in the hospital and 4 died within 6 months after discharge; 1 patient had ICD deactivation supported by palliative care services at home.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Therapy-limiting practices, including ICD deactivation, are not routine in the Italian centers participating in this study. The results emphasize the importance of integrating palliative care as a simultaneous process with intensive care to address the unmet needs of these patients and their families.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4037\/ajcc2024535","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T03:23:48Z","timestamp":1709263428000},"page":"145-148","source":"Crossref","is-referenced-by-count":5,"title":["Transitioning to Palliative Care in an Italian Cardiac Intensive Care Unit Network"],"prefix":"10.4037","volume":"33","author":[{"given":"Alice","family":"Sacco","sequence":"first","affiliation":[{"name":"Alice Sacco is a physician, Cardiac Intensive Care Unit, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Pagnesi","sequence":"additional","affiliation":[{"name":"Matteo Pagnesi is a physician, Cardiology, ASST Spedali Civili, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Frea","sequence":"additional","affiliation":[{"name":"Simone Frea is a physician, Intensive Cardiac Care Unit, Citt\u00e0 della Salute e della Scienza di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Briani","sequence":"additional","affiliation":[{"name":"Martina Briani is a physician, IRCCS Humanitas Research Hospital Rozzano, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta Sorini","family":"Dini","sequence":"additional","affiliation":[{"name":"Carlotta Sorini Dini is a physician, Division of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Bertaina","sequence":"additional","affiliation":[{"name":"Maurizio Bertaina is a physician, Division of Cardiology, San Giovanni Bosco Hospital, ASL Citt\u00e0 di Torino, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marini","sequence":"additional","affiliation":[{"name":"Marco Marini is a physician, Department of Cardiovascular Sciences, Clinic of Cardiology, Ospedali Riuniti, Ancona, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Trombara","sequence":"additional","affiliation":[{"name":"Filippo Trombara is a physician, Centro Cardiologico Monzino, IRCCS, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Villanova","sequence":"additional","affiliation":[{"name":"Luca Villanova is a physician, Cardiac Intensive Care Unit, De Gasperis Cardio Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Ravera","sequence":"additional","affiliation":[{"name":"Amelia Ravera is a physician, Department of Cardiology, \u201cSan Giovanni di Dio e Ruggi D\u2019Aragona\u201d Hopital-University, Salerno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Tavazzi","sequence":"additional","affiliation":[{"name":"Guido Tavazzi is a physician, Department of Clinical-Surgical, Diagnostic and Paediatric Sciences, Unit of Anaesthesia and Intensive Care, University of Pavia Italy Anesthesia and Intensive Care, Fondazione Policlinico San Matteo Hospital IRCCS, Anestesia e Rianimazione I, Pavia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Pappalardo","sequence":"additional","affiliation":[{"name":"Federico Pappalardo is a physician, Cardiothoracic and Vascular Anesthesia and Intensive Care, Azienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuccia","family":"Morici","sequence":"additional","affiliation":[{"name":"Nuccia Morici is a physician, IRCCS S. Maria Nascente\u2013Fondazione Don Carlo Gnocchi Onlus, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano","family":"Potena","sequence":"additional","affiliation":[{"name":"Luciano Potena is a physician, Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"8","key":"2024030103234043400_b1-0330145","doi-asserted-by":"publisher","first-page":"e003616","DOI":"10.1161\/CIRCOUTCOMES.117.003616","article-title":"Changes in primary noncardiac diagnoses over time among elderly cardiac intensive care unit patients in the United States","volume":"10","author":"Sinha","year":"2017","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"9","key":"2024030103234043400_b2-0330145","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1001\/jamacardio.2019.2467","article-title":"Demographics, care patterns, and outcomes of patients admitted to cardiac intensive care units: the Critical Care Cardiology Trials Network Prospective North American Multicenter Registry of Cardiac Critical Illness","volume":"4","author":"Bohula","year":"2019","journal-title":"JAMA Cardiol"},{"issue":"17","key":"2024030103234043400_b3-0330145","doi-asserted-by":"publisher","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: a comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"issue":"3","key":"2024030103234043400_b4-0330145","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1093\/ehjacc\/zuab121","article-title":"End-of-life care in the cardiac intensive care unit: a contemporary view from the Critical Care Cardiology Trials Network (CCCTN) Registry","volume":"11","author":"Fagundes","year":"2022","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"key":"2024030103234043400_b5-0330145","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.ijcard.2021.05.003","article-title":"Withdrawal of active treatments in terminally ill heart failure patients","volume":"336","author":"Sacco","year":"2021","journal-title":"Int J Cardiol"}],"container-title":["American Journal of Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/33\/2\/145\/154961\/145.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/33\/2\/145\/154961\/145.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T03:23:51Z","timestamp":1709263431000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article\/33\/2\/145\/32312\/Transitioning-to-Palliative-Care-in-an-Italian"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,1]]},"references-count":5,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,3,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ajcc2024535","relation":{},"ISSN":["1062-3264","1937-710X"],"issn-type":[{"value":"1062-3264","type":"print"},{"value":"1937-710X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,1]]}}}