AI Article Synopsis
- The study aimed to evaluate the prevalence of life support limitation (LSL) among pediatric patients who died after a stay in a pediatric intensive care unit (PICU) for at least 24 hours, along with the involvement of parents in the decision-making process.
- A retrospective analysis included 53 patients; findings revealed that 45.3% had LSL documented, with most of those who did have a do-not-resuscitate order, and half had life support withdrawn.
- The results indicated that LSLs were more common in older and more critically ill patients, with significant parental participation and a noted increase in both LSL prevalence and life support withdrawal compared to earlier cohorts.
Article Abstract
Objective: To determine the prevalence of life support limitation (LSL) in patients who died after at least 24h of a pediatric intensive care unit (PICU) stay, parent participation and to describe how this type of care is delivered.
Methods: Retrospective cohort study in a tertiary PICU at a university hospital in Brazil. All patients aged 1 month to 18 years who died were eligible for inclusion. The exclusion criteria were those brain death and death within 24h of admission.
Results: 53 patients were included in the study. The prevalence of a LSL report was 45.3%. Out of 24 patients with a report of LSL on their medical records only 1 did not have a do-not-resuscitate order. Half of the patients with a report of LSL had life support withdrawn. The length of their PICU stay, age, presence of parents at the time of death, and severity on admission, calculated by the Pediatric Index of Mortality 2, were higher in patients with a report of LSL. Compared with other historical cohorts, there was a clear increase in the prevalence of LSL and, most importantly, a change in how limitations are carried out, with a high prevalence of parental participation and an increase in withdrawal of life support.
Conclusions: LSLs were associated with older and more severely ill patients, with a high prevalence of family participation in this process. The historical comparison showed an increase in LSL and in the withdrawal of life support.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9431998 | PMC |
| http://dx.doi.org/10.1016/j.jped.2020.10.017 | DOI Listing |
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