Prevalence of questioning regarding life-sustaining treatment and time utilisation by forgoing treatment in francophone PICUs

Détails

ID Serval
serval:BIB_856064DF5327
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prevalence of questioning regarding life-sustaining treatment and time utilisation by forgoing treatment in francophone PICUs
Périodique
Intensive Care Med
Auteur(s)
Cremer R., Hubert P., Grandbastien B., Moutel G., Leclerc F.
ISSN
0342-4642
Statut éditorial
Publié
Date de publication
10/2011
Volume
37
Numéro
10
Pages
1648-55
Langue
anglais
Résumé
PURPOSE: Our goal is to assess the prevalence of questioning about the appropriateness of initiating or maintaining life-sustaining treatments (LST) in French-speaking paediatric intensive care units (PICUs) and to evaluate time utilisation related to decision-making processes (DMP). METHODS: 18-month, multicentre, prospective, descriptive, observational study in 15 French-speaking PICUs. RESULTS: Among the 5,602 children admitted, 410 died (7.3%), including 175 after forgoing LST (42.7% of deaths). LST was questioned in 308 children (5.5%) with a prevalence of 13.3 per 100 patient-days. More than 30% of children survived despite the appropriateness of LST being questioned (23% despite a decision to forgo treatment). Median caregiver time spent on making and presenting the decisions was 11 h per child. CONCLUSIONS: In this study, on any given day in each 10-bed PICU, there was more than one child for whom a DMP was underway. Of children, 23% survived despite a decision to forgo LST being made, which underlines the need to elaborate a care plan for these children. Also, DMP represented a large amount of staff time that is undervalued but necessary to ensure optimal palliative practice in PICU.
Mots-clé
*Intensive Care Units, Pediatric, *Refusal to Treat, Child, Preschool, Female, Humans, Infant, Language, Life Support Care/*statistics & numerical data, Male, Prospective Studies, Time Factors
Création de la notice
18/07/2019 12:48
Dernière modification de la notice
21/08/2019 5:33
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