Öz

Objective: To synthesize current evidence on the integration of palliative care into the care of critically ill patients, with a focus on models of delivery, symptom management, communication frameworks, ethical dimensions, and emerging trends in the field.

Materials and Methods: This narrative review was conducted through a structured literature search of PubMed, MEDLINE, and Cochrane databases using terms including ‘palliative care,’ ‘intensive care unit,’ ‘critical illness,’ ‘goals of care,’ and ‘symptom management,’ restricted to English-language articles published between 2000 and 2024. Articles were selected based on relevance to the review’s core domains and methodological quality, prioritizing randomized controlled trials, systematic reviews, and consensus guidelines where available.

Results: Early and structured integration of palliative care in the ICU is associated with improved symptom control, reduced rates of post-intensive care syndrome in patients and families, decreased non-beneficial interventions, shorter ICU stays at end of life, and lower healthcare costs without increasing mortality. Structured communication interventions and validated trigger-based referral criteria demonstrate consistent benefit. Evidence is strongest in medical ICU and oncology populations; emerging data support application across neurocritical care, cardiac, and surgical ICUs.

Conclusion: As ICU populations continue to age and life-sustaining treatments grow more complex, integrating palliative care principles alongside intensive therapies is essential to providing high-quality, goal-concordant, and compassionate critical care globally.

Anahtar Kelimeler: palliative care, intensive care unit, critical illness, goals of care, shared decision-making, symptom management, neurocritical care, cardiac intensive care, post-intensive care syndrome, end-of-life care

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