Palliative Care in Cardiac Intensive Care Units

lt;p>Massimo Romanò has been a Cardiologist in the Italian National Health System for 40 years. A past Head of Cardiac Electrophysiology at Garbagnate Milanese Hospital, Italy and past Head of the Cardiology Division at Vigevano Hospital, Italy, he has also been a Consultant at the Interdepartmental Center of Research on Palliative Care, University of Milan and a Member of the Organizing Committee for the 2^nd Level Master in Palliative Care at the University of Milan. Since the early 2000s he has developed a particular interest in advanced heart failure and in end-of-life issues. He was involved in a drafting an Italian position paper on shared care planning for end stage chronic organ failures. He has also published papers on palliative care issues in cardiac intensive care units, and on the deactivation of implanted cardiac devices at the end of life.

1. Epidemiology and patterns of care in the modern Cardiac Intensive Care Units.- 2. The intensive and advanced treatments in the Cardiac Intensive Care Units.- 3. Symptoms assessment and management.- 4. The meanings of prognosis: when and how to discuss it?.- 5. Informed consent, advance directives and shared care planning.- 6. Withholding or withdrawing life sustaining treatments.- 7. Deactivation of cardiac implanted electronic devices (CIEDs)at the end of life.- 8. Withdrawal  of Mechanical Circulatory Support in the Cardiac Intensive Care Unit.- 9. Do not attempt resuscitation orders in CICU.- 10. Palliative sedation in CICU: when, how, why.- 11. Nursing and the end of life in Cardiac Intensive Care Unit.- 12. Conflict management in CICU.- 13. Ethical considerations in the use of Technology  in the  CICU.- 14. Physician education and training in Palliative Care: a new challenge in modern Cardiac Intensive Care Unit.