2026-04-17T11:36:54Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1748322025-12-04T20:37:46Zcom_2072_1057col_2072_478800col_2072_478917

End-of-life care in a pediatric intensive care unit: the impact of the development of a palliative care unit Bobillo Pérez, Sara Segura Matute, Susana Girona Alarcón, Mònica Felipe Villalobos, Aida Balaguer Gargallo, Mònica Hernández Platero, Lluisa Solé Ribalta, Anna Guitart, Carmina Jordán García, Iolanda Cambra Lasaosa, Francisco José Pediatria intensiva Tractament pal·liatiu Mortalitat infantil Pediatric intensive care Palliative treatment Infant mortality Background: The purpose of this paper is to describe how end-of-life care is managed when life-support limitationis 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 In absolute numbers, respiratory support was the main type of support withdrawn.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. 2021-03-09T14:10:57Z 2021-03-09T14:10:57Z 2020-05-28 2021-03-09T14:10:57Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 1472-684X https://hdl.handle.net/2445/174832 703227 32466785 eng Reproducció del document publicat a: https://doi.org/10.1186/s12904-020-00575-4 BMC Palliative Care, 2020, vol. 19, num. 74 https://doi.org/10.1186/s12904-020-00575-4 cc-by (c) Bobillo Pérez, Sara et al., 2020 http://creativecommons.org/licenses/by/3.0/es info:eu-repo/semantics/openAccess 8 p. application/pdf BioMed Central Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)