Estado actual y utilidad de la autopsia clínica en una unidad de cuidados intensivos pediátricos

Soler, P. García; Martínez-Ferriz, M.C.; Carballido, S. Martín; Manso, G. Milano

doi:10.1016/j.anpedi.2012.05.009

Cited by 1 publication

(1 citation statement)

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“…Finally, autopsy was performed in one out of three patients. This could be useful in children who die without a definitive diagnosis, to provide further information and guide genetic counselling to the family 26 . Organ and tissue donation can also help families to give a meaning to their child's death, which can be complementary to optimal PC 27 .…”

Section: Discussionmentioning

confidence: 99%

How do hospitalised children die? The context of death and end‐of‐life decision‐making

Serrano-Pejenaute

Carmona-Nunez

Zorrilla-Sarriegui

et al. 2023

J Paediatrics Child Health

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Aim The decrease in childhood mortality, the growing clinical complexity and the greater technification of intensive care units have changed the circumstances of death of paediatric patients. The aim of this study is to describe the context of death and end‐of‐life decision‐making. Methods Single‐centre, retrospective, observational study of deaths in inpatients or home hospitalised children under 18 years old between 2011 and 2021. Demographic data, pathological history and circumstances of death were obtained from the medical record. The whole study period was divided into two halves for the analysis of the temporal trends. Results A total of 358 patients died, 63.2% under the age of 1 year old; 86.9% had underlying life‐limiting illnesses and 73.2% died in the intensive care unit, with no differences between the two time periods. Death at home was significantly higher in the second study period (3.8% vs. 9%). A total of 20.1% died during advanced cardiopulmonary resuscitation. Life‐sustaining treatment was withheld or withdrawn in 53.6%, with no differences between the time courses. Life‐sustaining treatment was withheld mainly in patients with neurological, metabolic and oncological conditions, and less frequently in patients with cardiovascular or respiratory diseases or who were previously healthy. Most patients coded as palliative care (PC) or followed up by PC teams had an advance care plan (ACP) recorded, while in the others it was infrequent. PC coding, following by PC teams and ACP recording increased in the last years of the study. Conclusions Death of children in our setting usually occurs in relation to complex underlying pathology and after the decision of withdrawing or withholding life‐sustaining treatment. In this context, PC and ACP acquire greater importance. In our study, PC involvement resulted in better documentation of ACP and PC coding.

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Section: Discussionmentioning

confidence: 99%