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Dublin Core
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Title
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May 2020 List
Text
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Citation List Month
May 2020 List
URL Address
<a href="http://doi.org/10.1097/PCC.0000000000002259" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/PCC.0000000000002259</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Comparison of End-of-Life Care Practices Between Children With Complex Chronic Conditions and Neonates Dying in an ICU Versus Non-ICUs: A Substudy of the Pediatric End-of-LIfe CAre Needs in Switzerland (PELICAN) Project
Publisher
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Pediatric Critical Care Medicine
Date
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2020
Subject
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children; complex chronic conditions; end-of-life care; ICU; intensive care unit; neonates; non-ICU; pediatric; PELICAN project; Switzerland
Creator
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Ramelet A; Bergstraesser E; Grandjean C; Dorsaz A; Fahrni-Nater P; Cignacco E; Zimmerman K; Consortium on behalf of the Pediatric End-of-LIfe CAre Needs in Switzerland (PELICAN)
Description
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Objectives: To describe and compare characteristics of care provided at the end of life for children with chronic complex conditions and neonates who died in an ICU with those who died outside an ICU. Design: Substudy of a nation-wide retrospective chart review. Setting: Thirteen hospitals, including 14 pediatric and neonatal ICUs, two long-term institutions, and 10 community-based organizations in the three language regions of Switzerland. Patients: One hundred forty-nine children (0–18 yr) who died in the years 2011 or 2012. Causes of death were related to cardiac, neurologic, oncological, or neonatal conditions. Interventions: None. Measurements and Main Results: Demographic and clinical characteristics, therapeutic procedures, circumstances of death, and patterns of decisional processes were extracted from the medical charts. Ninety-three (62%) neonates (median age, 4 d) and children (median age, 23 mo) died in ICU, and 56 (38%) with a median age of 63 months outside ICU. Generally, ICU patients had more therapeutic and invasive procedures, compared with non-ICU patients. Changes in treatment plan in the last 4 weeks of life, such as do-not-resuscitate orders occurred in 40% of ICU patients and 25% of non-ICU patients (p < 0.001). In the ICU, when decision to withdraw life-sustaining treatment was made, time to death in children and newborns was 4:25 and 3:00, respectively. In institutions where it was available, involvement of specialized pediatric palliative care services was recorded in 15 ICU patients (43%) and in 18 non-ICU patients (78%) (p = 0.008). Conclusions: This nation-wide study demonstrated that patients with a complex chronic condition who die in ICU, compared with those who die outside ICU, are characterized by fast changing care situations, including when to withdraw life-sustaining treatment. This highlights the importance of early effective communication and shared decision making among clinicians and families.
Identifier
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<a href="http://doi.org/10.1097/PCC.0000000000002259" target="_blank" rel="noreferrer noopener">10.1097/PCC.0000000000002259</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).
2020
Bergstraesser E
Cignacco E
Complex Chronic Conditions
Consortium on behalf of the Pediatric End-of-LIfe CAre Needs in Switzerland (PELICAN)
Dorsaz A
End Of Life Care
Fahrni-Nater P
Grandjean C
Icu
May 2020 List
non-ICU
Pediatric
Pediatric Critical Care Medicine
PELICAN project
Ramelet A
Zimmerman K