Therapeutic termination in cardiological intensive care units: decision-making criteria between ethics and clinical studies

In the last years dramatic changes in clinical and epidemiological characteristics of patients admitted to cardiac intensive care units have been observed. Aging population, non-ischemic cardiovascular diseases, acute and chronic severe comorbidities, all increased the susceptibility to develop life-threatening critical settings. In this context, palliative care programs are needed more frequently. In this review, the ethical and clinical criteria to withdrawing and withholding artificial cardiocirculatory, respiratory and renal supports are analyzed, as well as the cultural delays of cardiologists involved in this peculiar clinical setting.