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American Journal of Hospice and Palliative Medicine®
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Management of Patients With Metastatic Malignancy in the Intensive Care Unit

Paul E. Marik, MD, FCCP, FCCM

Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University; Thomas Jefferson University, 1015 Chestnut St, Suite M100, Philadelphia, PA 19107

Intensive care units serve to provide temporary physiologic support to patients with reversible organ failure. However, with increasing frequency, patients with end-stage and terminal illnesses are being admitted to the intensive care unit. Indeed, in the United States, a third of all patients with terminal metastatic malignancy are admitted to the intensive care unit, and 60% of all hospital deaths occur after such an admission. In many instances, admission to an intensive care unit serves only to transform death into a prolonged, painful, and undignified process. In patients with a terminal illness, the focus should be on measures that ensure comfort, and admission to an intensive care unit should generally be avoided. Intensivists, who are charged with making the best use of limited resources, should ultimately be the individuals who determine the appropriateness of admitting such patients to the intensive care unit.

Key Words: terminal illness • metastatic malignancy • intensive care units

American Journal of Hospice and Palliative Medicine®, Vol. 23, No. 6, 479-482 (2007)
DOI: 10.1177/1049909106294921
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