Guias de ingreso, alta y triage para las unidades de cuidados intensivos pediátricos en España

Oliva, Pedro de la; Cambra-Lasaosa, Francisco José; Quintana-Díaz, Manuel; Galán, Corsino Rey; Sánchez-Díaz, Juan Ignacio; Martín-Delgado, María Cruz; Carlos-Vicente, Juan Carlos de; Hernández-Rastrollo, Ramón; Peña, M.S. Holanda; Pilar, Javier; Ocete-Hita, Esther; Rodrı́guez-Núñez, Antonio; Serrano-González, Ana; Blanch, Luis Enrique Bruno

doi:10.1016/j.medin.2017.10.015

Cited by 5 publications

(1 citation statement)

References 28 publications

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“…Palliative physicians and intensivists also work together in those situations in which intensive care could provide comfort at the end of a patient's life. Some criteria for palliative care in the PICU were recently published [19]. Differences according to epidemiological characteristics between our results and other previous studies were not detected.…”

Section: Discussioncontrasting

confidence: 69%

End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit

et al. 2020

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Background: The purpose of this paper is to describe how end-of-life care is managed when life-support limitation is decided in a Pediatric Intensive Care Unit and to analyze the influence of the further development of the Palliative Care Unit. Methods: A 15-year retrospective study of children who died after life-support limitation was initiated in a pediatric intensive care unit. Patients were divided into two groups, pre-and post-palliative care unit development. Epidemiological and clinical data, the decision-making process, and the approach were analyzed. Data was obtained from patient medical records. Results: One hundred seventy-five patients were included. The main reason for admission was respiratory failure (86/175). A previous pathology was present in 152 patients (61/152 were neurological issues). The medical team and family participated together in the decision-making in 145 cases (82.8%). The family made the request in 10 cases (9 vs. 1, p = 0.019). Withdrawal was the main life-support limitation (113/175), followed by withholding lifesustaining treatments (37/175). Withdrawal was more frequent in the post-palliative group (57.4% vs. 74.3%, p = 0.031). In absolute numbers, respiratory support was the main type of support withdrawn. Conclusions: The main cause of life-support limitation was the unfavourable evolution of the underlying pathology. Families were involved in the decision-making process in a high percentage of the cases. The development of the Palliative Care Unit changed life-support limitation in our unit, with differences detected in the type of patient and in the strategy used. Increased confidence among intensivists when providing end-of-life care, and the availability of a Palliative Care Unit may contribute to improvements in the quality of end-of-life care.

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Section: Discussioncontrasting

confidence: 69%