Decision-Making, Ethics, and End-of-Life Care in Pediatric Extracorporeal Membrane Oxygenation: A Comprehensive Narrative Review.
Pediatr Crit Care Med
; 22(9): 806-812, 2021 09 01.
Article
em En
| MEDLINE
| ID: mdl-33989251
ABSTRACT
OBJECTIVES:
Pediatric extracorporeal membrane oxygenation is associated with significant morbidity and mortality. We sought to summarize literature on communication and decision-making, end-of-life care, and ethical issues to identify recommended approaches and highlight knowledge gaps. DATA SOURCES PubMed, Embase, Web of Science, and Cochrane Library. STUDY SELECTION We reviewed published articles (1972-2020) which examined three pediatric extracorporeal membrane oxygenation domains 1) decision-making or communication between clinicians and patients/families, 2) ethical issues, or 3) end-of-life care. DATA EXTRACTION Two reviewers independently assessed eligibility using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. DATASYNTHESIS:
Of 2,581 publications screened, we identified one systematic review and 35 descriptive studies. No practical guides exist for communication and decision-making in pediatric extracorporeal membrane oxygenation. Conversation principles and parent/clinician perspectives are described. Ethical issues related to consent, initiation, discontinuation, resource allocation, and research. No patient-level synthesis of ethical issues or end-of-life care in pediatric extracorporeal membrane oxygenation was identified.CONCLUSIONS:
Despite numerous ethical issues reported surrounding pediatric extracorporeal membrane oxygenation, we found limited patient-level research and no practical guides for communicating with families or managing extracorporeal membrane oxygenation discontinuation.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Assistência Terminal
/
Oxigenação por Membrana Extracorpórea
Tipo de estudo:
Prognostic_studies
/
Systematic_reviews
Limite:
Child
/
Humans
Idioma:
En
Revista:
Pediatr Crit Care Med
Assunto da revista:
PEDIATRIA
/
TERAPIA INTENSIVA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Marrocos