End‐Of‐Life Care in a Cardiac Intensive Care Unit: A Retrospective Analysis of Interventions During the Last 48 Hours

BACKGROUND: Palliative care in intensive care units should be planned jointly with patients and their families and documented in medical records. Proximity to death should prompt reassessment of the therapeutic strategy. AIM: To analyse the interventions performed during the last 48 h in patients who died in the cardiac intensive care unit. STUDY DESIGN: A retrospective cohort study was conducted in the cardiac intensive care unit of a large university hospital in Southeastern Brazil between March and April 2025. The deaths that occurred in 2022, 2023 and 2024 were evaluated. RESULTS: A total of 83 deaths with more than 5 days of hospital admission were analysed. There were few records documenting patients' and families' wishes. Only 12 (14.5%) records of limitations of life-sustaining treatments and 11 (13.3%) records of do-not-resuscitate orders directed to the healthcare team were identified. CONCLUSION: Interventions intended to modify the course of the disease exceeded those aimed at palliative care in our cohort. RELEVANCE TO CLINICAL PRACTICE: These findings may support the implementation of trigger-based protocols for palliative care assessment in cardiac ICUs, the development of training strategies focused on communication and documentation of patient preferences for ICU teams, the strengthening of the role of the multidisciplinary team, and standardized comfort-focused interventions during the last 48 h of life.