Palliative care, resuscitation status, and end-of-life considerations in pediatric anesthesia

Abstract

Purpose of review To familiarize pediatric anesthesiologists with primary palliative care procedural communication skills and recommendations for discussions involving complex medical decision-making or advance care planning, such as discussions about resuscitation status. Recent findings Recent publications highlight the benefits of pediatric palliative care (PPC) for seriously ill patients and their families, and how PPC principles might be applied to perioperative communication and decision-making. Both prospective and retrospective reports reveal improved quality of life, symptom management, and avoidance of unnecessary interventions when PPC is introduced early for a child with serious illness. Summary Pediatric anesthesiologists will, at some point, care for a child with serious illness who would benefit from PPC. It is important that all members of the perioperative care team are familiar with primary PPC procedural communication skills and models for approaching discussions about goals of care, shared decision-making, and advance care planning. Pediatric anesthesiologists should be incorporated as early as possible in team discussions about potential procedures requiring sedation for seriously ill children.

Palliative Sedation Therapy Practice Comparison – A Survey of Pediatric Palliative Care and Pain Management Specialists

“…3 Palliative care (PC) focuses on reducing the burden of suffering through symptom management, psychosocial support, improved advance care planning, and reducing parental grief and depression. 3,4 Early integration of PC in the context of life-threatening illness is important for improving quality of life (QOL), reducing suffering across the trajectory of life-threatening diseases, and addressing the burden of symptoms at the EOL. [5][6][7][8][9] If symptom management strategies remain ineffective despite multidisciplinary interventions, relief from suffering may necessitate palliative sedation therapy (PST), defined as "the use of sedative medications to relieve intolerable and refractory distress by the reduction in patient consciousness".…”

Home Palliative Care during the COVID-19 Pandemic: A Scoping Review

“… 1 , 3 In addition, the palliative care team discusses with patients advance care planning, a process that enables patients to express their values and preferences for future care. 4 …”

“…1,3 In addition, the palliative care team discusses with patients advance care planning, a process that enables patients to express their values and preferences for future care. 4 Palliative care can be offered in different settings, such as hospitals, hospice facilities, out-patient clinics, nursing homes, and home. 5 Home has been the desired place to stay and die for most patients if the burden is not too high for family members.…”