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AAP Grand Rounds 4:48-49 (2000)
© 2000 American Academy of Pediatrics

CRITICAL CARE

End of Life Care in the PICU

Source: Burns JP, Mitchell C, Outwater KM, et al. End-of-life care in the pediatric intensive care unit after the forgoing of life-sustaining treatment. Crit Care Med. 2000;28:3060–3066.

The first 20% of the full text of this article appears below.

The authors prospectively tracked 100 consecutive deaths among children in the multidisciplinary pediatric intensive care units at Boston Children’s Hospital, Tufts-New England Medical Center and Massachusetts General Hospital. A self-administered, anonymous questionnaire was administered within 2 weeks of the death to the PICU attending and the primary nurse (selected by the site investigator) who cared for each of the 53 children who died after withdrawal of life-sustaining treatments. The questionnaire addressed decision making, management steps and level of satisfaction with terminal care1 and was modified to apply to children.

In 47 cases the ventilator was removed and in 6 cases ventilator settings were decreased despite deteriorating vital signs. Sedative and/or analgesics were administered to 89% (n=47) of the patients. . . . [Full Text of this Article]

Heather Keenan, MD
Critical Care Medicine, University of North Carolina, Chapel Hill, NC