This article reported a successful cesarean section performed on a woman with 37 +6 weeks of gestation after heart-lung transplantation (HLTx) at the Second Xiangya Hospital of Central South University. The patient was a 29-year-old woman with singleton pregnancy who underwent HLTx seven years ago. During pregnancy, she was treated with azathioprine and tacrolimus to suppress immune rejection. The patient was in New York Heart Association (NYHA) class Ⅰ and had no fever or shortness of breath. Prenatal examinations indicated that the mother and the fetus were in good condition. A baby girl was delivered successfully at full term by a transverse lower-segment cesarean section under spinal anesthesia. Both the mother and the child were healthy at follow-up of 42 d after discharge.

ObjectiveTo understand intensive care unit （ICU） doctors’ opinions and suggestions on implementing palliative care， and provides a reference basis for the implementation of palliative care in Chinese ICU. MethodsA purposive sampling technique was used to conduct one-on-one semi-structured interviews with 11 ICU doctors. Colaizzi’s phenomenological analysis method was utilized to code， classify， interpret， and comprehensively analyze the interview data. ResultsA total of 4 themes and 18 sub-themes was extracted， including cognitive biases toward palliative care， the belief that implementing palliative care in the ICU has significant humanistic implications （palliative care practice is the most perfect embodiment of medical humanities， palliative care in the ICU can alleviate patient pain and reduce invasive operations， palliative care can achieve comfortable care for ICU patients， palliative care focuses on maintaining the dignity of ICU patients， palliative care can pay attention to the inner voice of ICU patients， and implementing palliative care will help to more effectively allocate resources）， difficulties faced by ICU in carrying out palliative care （lack of clarity in relevant policies at the legal level， closed management environment in the ICU， insufficient manpower in the ICU and lack of palliative care professional team， inadequate understanding of ICU patients’ families， lack of death education， not included in medical insurance payments， and lack of communication skills of young doctors）， strategies to promote the development of palliative care in the ICU （ICU palliative care can be piloted first， the development of ICU palliative care screening tools will help with the development of palliative care， the palliative environment and the handling of death procedures can be further optimized， and the application and implementation of scientific methods to shorten the gap between evidence and practice of palliative care）. ConclusionsThe integration of palliative care and ICU in China is still blank. The significance of implementing palliative care in ICU should be emphasized， ICU doctors’ knowledge and skills of palliative care should be improved from multiple perspectives， patient preference should be emphasized to improve the knowledge and acceptance of palliative care of ICU patients’ families， and the promotion of palliative care in ICU clinical practice should be pioneered and piloted.