Quality of Life in Critically Ill Patients: A Systematic Review.

Objective: This paper aims to present a comprehensive literature review of Quality of Life (QOL) in patients who are suffering from serious medical illness as evidenced by receiving treatment in the intensive care setting. By examining the instruments used to measure QOL, as well as the factors that influence it, this review will explore the relevance of QOL to patient care and management. Data Sources: From Medline and other online resources, over 467 articles were identified, of which 73 articles were selected for inclusion in this review by three independent reviewers. The reviewers reached a consensus using pre-defined selection criteria. Study Selection Criteria: Articles had to: 1) be written in English or have an available published English translation, 2) be published in a peer-reviewed journal, 3) study adult humans, 4) focus on serious medical illnesses, such as sepsis and MI (myocardial infarction), rather than focusing exclusively on terminal illnesses (any study design was accepted), and 5) use at least one QOL measure. Data Extraction: The study selection process yielded 73 articles. Research methodology and key findings were derived from the full text and tables of the selected studies. Data Synthesis: QOL is very poor in gravely ill medical patients and continues to decline with further deterioration of medical status. A model that incorporates QOL and the severity of the medical illness, in addition to the patient’s wishes, might have the potential to improve overall QOL for patients and their families and guide end-of-life decisions. Conclusions: A formal assessment of the patient's QOL and final wishes could assist the patient, their loved ones, and the treating physician in making critical decisions about how to improve QOL through comfort/palliative care.

Control of pain with topical plant medicines

Pain is normally treated with oral nonsteroidal anti-inflammatory agents and opioids. These drugs are dangerous and are responsible for many hospitalizations and deaths. It is much safer to use topical preparations made from plants to treat pain, even severe pain. Topical preparations must contain compounds that penetrate the skin, inhibit pain receptors such as transient receptor potential cation channels and cyclooxygenase-2, to relieve pain. Inhibition of pain in the skin disrupts the pain cycle and avoids exposure of internal organs to large amounts of toxic compounds. Use of topical pain relievers has the potential to save many lives, decrease medical costs and improve therapy.