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

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Affiliation:
      Disorders of Immunity and Respiration of the Pediatric Critical Patient Research Group, Institut Recerca Hospital Sant Joan de Déu, Universitat de Barcelona, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
      Pediatric Intensive Care Unit Service, Hospital Sant Joan de Déu and University of Barcelona, Passeig Sant Joan de Déu, 2, 08950, Barcelona, Esplugues de Llobregat, Spain
      Paediatric Infectious Diseases Research Group, Institut Recerca Hospital Sant Joan de Déu, CIBERESP, Passeig Sant Joan de Déu, 2, 08950, Esplugues de Llobregat, Barcelona, Spain
    • Subject Terms:
    • Subject Terms:
    • Abstract:
      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 life-sustaining 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 In absolute numbers, respiratory support was the main type of support withdrawn.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.
    • Journal Subset:
      Biomedical; Europe; Nursing; UK & Ireland
    • ISSN:
      1472-684X
    • MEDLINE Info:
      NLM UID: 101088685
    • Publication Date:
      20200601
    • Publication Date:
      20200601
    • DOI:
      http://dx.doi.org/10.1186/s12904-020-00575-4
    • Accession Number:
      143476019
  • Citations
    • ABNT:
      BOBILLO-PEREZ, S. et al. End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit. BMC Palliative Care, [s. l.], v. 19, n. 1, p. 1–8, 2020. DOI 10.1186/s12904-020-00575-4. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143476019. Acesso em: 2 jul. 2020.
    • AMA:
      Bobillo-Perez S, Segura S, Girona-Alarcon M, et al. End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit. BMC Palliative Care. 2020;19(1):1-8. doi:10.1186/s12904-020-00575-4.
    • AMA11:
      Bobillo-Perez S, Segura S, Girona-Alarcon M, et al. End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit. BMC Palliative Care. 2020;19(1):1-8. doi:10.1186/s12904-020-00575-4
    • APA:
      Bobillo-Perez, S., Segura, S., Girona-Alarcon, M., Felipe, A., Balaguer, M., Hernandez-Platero, L., Sole-Ribalta, A., Guitart, C., Jordan, I., & Cambra, F. J. (2020). End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit. BMC Palliative Care, 19(1), 1–8. https://doi.org/10.1186/s12904-020-00575-4
    • Chicago/Turabian: Author-Date:
      Bobillo-Perez, Sara, Susana Segura, Monica Girona-Alarcon, Aida Felipe, Monica Balaguer, Lluisa Hernandez-Platero, Anna Sole-Ribalta, Carmina Guitart, Iolanda Jordan, and Francisco Jose Cambra. 2020. “End-of-Life Care in a Pediatric Intensive Care Unit: The Impact of the Development of a Palliative Care Unit.” BMC Palliative Care 19 (1): 1–8. doi:10.1186/s12904-020-00575-4.
    • Harvard:
      Bobillo-Perez, S. et al. (2020) ‘End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit’, BMC Palliative Care, 19(1), pp. 1–8. doi: 10.1186/s12904-020-00575-4.
    • Harvard: Australian:
      Bobillo-Perez, S, Segura, S, Girona-Alarcon, M, Felipe, A, Balaguer, M, Hernandez-Platero, L, Sole-Ribalta, A, Guitart, C, Jordan, I & Cambra, FJ 2020, ‘End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit’, BMC Palliative Care, vol. 19, no. 1, pp. 1–8, viewed 2 July 2020, .
    • MLA:
      Bobillo-Perez, Sara, et al. “End-of-Life Care in a Pediatric Intensive Care Unit: The Impact of the Development of a Palliative Care Unit.” BMC Palliative Care, vol. 19, no. 1, May 2020, pp. 1–8. EBSCOhost, doi:10.1186/s12904-020-00575-4.
    • Chicago/Turabian: Humanities:
      Bobillo-Perez, Sara, Susana Segura, Monica Girona-Alarcon, Aida Felipe, Monica Balaguer, Lluisa Hernandez-Platero, Anna Sole-Ribalta, Carmina Guitart, Iolanda Jordan, and Francisco Jose Cambra. “End-of-Life Care in a Pediatric Intensive Care Unit: The Impact of the Development of a Palliative Care Unit.” BMC Palliative Care 19, no. 1 (May 28, 2020): 1–8. doi:10.1186/s12904-020-00575-4.
    • Vancouver/ICMJE:
      Bobillo-Perez S, Segura S, Girona-Alarcon M, Felipe A, Balaguer M, Hernandez-Platero L, et al. End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit. BMC Palliative Care [Internet]. 2020 May 28 [cited 2020 Jul 2];19(1):1–8. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=rzh&AN=143476019