Forgoing life-sustaining treatments: how the decision is made in French pediatric intensive care units

Title

Forgoing life-sustaining treatments: how the decision is made in French pediatric intensive care units

Creator

Devictor DJ; Nguyen DT; Groupe Francophone de Reanimationet d'Urgences Pediatriques

Publisher

Critical Care Medicine

Date

2001

Subject

Child; Cross-Sectional Studies; Female; Humans; infant; Male; Intensive Care Units; Prospective Studies; Professional-Family Relations; Life Support Care; Pediatric; adolescent; Preschool; Empirical Approach; Professional Patient Relationship; patient care team; Death and Euthanasia; decision making; infant; Practice Guidelines; Newborn; ICU Decision Making; France

Description

OBJECTIVES: The decision to forgo life support is frequently made in pediatric intensive care units (PICUs). A group of experts is currently preparing recommendations for guidelines concerning this decision-making process in France. We have performed a prospective study to help the experts. This study documents how children die in French PICUs and how the decision to limit life support is made. DESIGN: A multicenter, prospective, cross-sectional study. SETTING: Thirty-three multidisciplinary PICUs in university hospitals. PATIENTS: All consecutive deaths were recorded over a 4-month period. Children who died after a medical decision to forgo life-sustaining treatment were included in group 1 and children who died from other causes were included in group 1. MAIN RESULTS: A total of 264 consecutive children died, 40.1% from group 1 and 59.8% from group 2. Patients of both groups were primarily admitted for acute respiratory failure (group 1, 50.8%; group 2, 52.6%). Neurologic emergencies were more frequent in patients in group 1, whereas patients with cardiovascular failures were more frequent in group 2. When there was a question of whether to pursue life-sustaining treatment, the parents' opinions were recorded in 72.1% of cases. A specific meeting was called to make this decision in 80.1% of cases. This meeting involved the medical staff in all cases. Parents were aware of the meeting in 10.7% of cases. The conclusion of the meeting was reported to the parents in 18.7% of cases and documented in the patient's medical record in 16% of cases. Experts who were not members of the PICU staff were invited to give their opinion in 62.2% of cases. CONCLUSIONS: The decision to forgo life-sustaining treatment is frequently made for children dying in French PICUs. Guidelines must be available to help the medical staff reach this decision. Knowledge of the decision-making process in French PICUs provides the experts with information needed to elaborate such recommendations.
2001

Rights

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).

Type

Journal Article

Citation List Month

Backlog

Pages

1356-1359

Issue

7

Volume

29

Citation

Devictor DJ; Nguyen DT; Groupe Francophone de Reanimationet d'Urgences Pediatriques, “Forgoing life-sustaining treatments: how the decision is made in French pediatric intensive care units,” Pediatric Palliative Care Library, accessed September 26, 2021, https://pedpalascnetlibrary.omeka.net/items/show/11997.

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