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November 2018 List
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November 2018 List
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<a href="http://doi.org/10.1016/j.ejpn.2018.09.002" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.ejpn.2018.09.002</a>
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Title
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The role of the neuropediatrician in pediatric intensive care unit: Diagnosis, therapeutics and major participation in collaborative multidisciplinary deliberations about life-sustaining treatments' withdrawal
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European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
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2018
Subject
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Life sutaining treatment;Neuropediatrician;Palliative care;Pediatric intensive care unit;Withdrawal withholding treatment
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Toulouse J;Hully M;Brossier D;Viallard ML;de Saint Blanquat L;Renolleau S;Kossorotoff M;Desguerre I
Description
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BACKGROUND: In Pediatric Intensive Care Unit (PICU) two types of population require the intervention of neuropediatricians (NP): chronic brain diseases' patients who face repetitive and prolonged hospitalizations, and patients with acute brain failure facing the risk of potential neurologic sequelae, and both conditions may result in a limitation of life-sustaining treatments (LLST) decision. OBJECTIVE: To assess NP's involvement in LLST decisions within the PICU of a tertiary hospital. METHOD: Retrospective study of medical reports of patients hospitalized during 2014 in the Necker-Hospital PICU. Patients were selected using keywords ("cardiorespiratory arrest", "death", "withdrawal of treatment", "palliative care", "acute brain failure", or "chronic neurological disease"), and/or if they were assessed by a NP during the hospitalization. Demographic and medical data were analysed, including the NP's assessment and data about Collaborative Multidisciplinary Deliberation (CMD) to discuss potential LLST. RESULTS: Among 1160 children, 274 patients were included and 142 (56%) were assessed by a NP during their hospitalization for diagnosis (n = 55) and/or treatment (n = 95) management. NP was required for 59%-100% of patients with neurological acute failure, and for 14-44% of patients with extra neurological failure. A LLST decision was taken after a CMD for 27 (9.8%) of them, and a NP was involved in 19/27 (70%) of these decisions that occurred during the hospitalization (n = 19) or before (n = 8).12 patients died thereafter the LLST decision (40% of the 30 dead patients). CONCLUSION: NP are clearly involved in the decision-process of LLST for patients admitted in PICU, claiming for close collaboration to improve current practices and the quality of the care provided to children.
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<a href="http://doi.org/10.1016/j.ejpn.2018.09.002" target="_blank" rel="noreferrer noopener">10.1016/j.ejpn.2018.09.002</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2018
Brossier D
de Saint Blanquat L
Desguerre I
European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
Hully M
Kossorotoff M
Life sutaining treatment
Neuropediatrician
November 2018 List
Palliative Care
Pediatric Intensive Care Unit
Renolleau S
Toulouse J
Viallard ML
Withdrawal withholding treatment