Life-Sustaining Treatment Status at the Time of Death in a Japanese Pediatric Intensive Care Unit.
Am J Hosp Palliat Care
; 35(5): 767-771, 2018 May.
Article
em En
| MEDLINE
| ID: mdl-29179574
ABSTRACT
BACKGROUND:
Substantial variability exists among countries regarding the modes of death in pediatric intensive care units (PICUs). However, there is limited information on end-of-life care in Japanese PICUs. Thus, this study aimed to elucidate the characteristics of end-of-life care practice for children in a Japanese PICU.METHODS:
We examined life-sustaining treatment (LST) status at the time of death based on medical chart reviews from 2010 to 2014. All deaths were classified into 3 groups limitation of LST (limitation group, death after withholding or withdrawal of LST or a do not attempt resuscitation order), no limitation of LST (no-limitation group, death following failed resuscitation attempts), or brain death (brain death group).RESULTS:
Of the 62 patients who died, 44 (71%) had limitation of LST, 18 (29%) had no limitation of LST, and none had brain death. In the limitation group, the length of PICU stay was longer than that in the no-limitation group (13.5 vs 2.5 days; P = .01). The median time to death after the decision to limit LST was 2 days (interquartile range 1-5.5 days), and 94% of the patients were on mechanical ventilation at the time of death in the limitation group.CONCLUSIONS:
Although limiting LST was a common practice in end-of-life care in a Japanese PICU, a severe limitation of LST such as withdrawal from the ventilator was hardly practiced, and a considerable LST was still provided at the time of death.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Assistência Terminal
/
Unidades de Terapia Intensiva Pediátrica
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Tomada de Decisões
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Cuidados para Prolongar a Vida
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article