RESUMO
End-of-life care (EOLC) exemplifies the joint mission of intensive and palliative care (PC) in their human-centeredness. The explosion of technological advances in medicine must be balanced with the culture of holistic care. Inevitably, it brings together the science and the art of medicine in their full expression. High-quality EOLC in the ICU is grounded in evidence, ethical principles, and professionalism within the framework of the Law. Expert professional statements over the last two decades in India were developed while the law was evolving. Recent landmark Supreme Court judgments have necessitated a review of the clinical pathway for EOLC outlined in the previous statements. Much empirical and interventional evidence has accumulated since the position statement in 2014. This iteration of the joint Indian Society of Critical Care Medicine-Indian Association of Palliative Care (ISCCM-IAPC) Position Statement for EOLC combines contemporary evidence, ethics, and law for decision support by the bedside in Indian ICUs. How to cite this article: Mani RK, Bhatnagar S, Butola S, Gursahani R, Mehta D, Simha S, et al. Indian Society of Critical Care Medicine and Indian Association of Palliative Care Expert Consensus and Position Statements for End-of-life and Palliative Care in the Intensive Care Unit. Indian J Crit Care Med 2024;28(3):200-250.
RESUMO
Cough is a commonly frequent debilitating symptom that is often viewed as an intractable problem. However, specialist cough clinics report very high success rate, in the order of 90%.6 The key to successful management is to establish a diagnosis and treat the cause. Idiopathic cough is rare and commonly misdiagnosed, because of the failure to recognize that cough is often caused from sites outside the airway. Asthma, gastric reflux and rhinitis are common causes from three different anatomical areas and the realms of different specialists. This problem is complicated by the frequently atypical presentation of patients with cough. Thus, patients with cough-predominant asthma may not exhibit bronchoconstriction, and patients with reflux-associated cough may have no associated reflux symptoms such as heartburn. Hence, this warrants a detailed history and evaluation to reach a diagnosis for successful treatment. The following article aims to provide a framework for a logical approach, for patients with this highly disabling symptom.
