Palliative extubation: five-year experience in a pediatric hospital

Title

Palliative extubation: five-year experience in a pediatric hospital

Creator

Affonseca CA; Carvalho LFA; Quinet RPB; Guimaraes MCDC; Cury VF; Rotta AT

Publisher

Jornal de Pediatria

Date

2019

Subject

Children; Criancas; Cuidados no fim da vida; Cuidados paliativos; End-of-life care; Ethics; Etica; Extubacao paliativa; Palliative care; Palliative extubation; Suspensao de tratamento; Withdrawal treatment

Description

OBJECTIVE: To present the characteristics of pediatric patients with chronic and irreversible diseases who underwent palliative extubation. METHOD: This is a descriptive analysis of a case series of patients admitted to a public pediatric hospital, with chronic and irreversible diseases, permanently dependent on ventilatory support, who underwent palliative extubation between April 2014 and May 2019. The following information was collected from the medical records: demographic data, diagnosis, duration and type of mechanical ventilation; date, time, and place of palliative extubation; medications used; symptoms observed; and hospital outcome. RESULTS: A total of 19 patients with a mean age of 2.2 years underwent palliative extubation. 68.4% of extubations were performed in the ICU; 11 patients (57.9%) died in the hospital. The time between mechanical ventilation withdrawal and in-hospital death ranged from 15min to five days. Thirteen patients had an orotracheal tube and the others a tracheostomy. The main symptoms were dyspnea and pain, and the main drugs used to control symptoms were opioids and benzodiazepines. CONCLUSIONS: It was not possible to identify predictors of in-hospital death after ventilatory support withdrawal. Palliative extubation requires specialized care, with the presence and availability of a multidisciplinary team with adequate training in symptom control and palliative care.

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).

Citation List Month

November 2019 List

Collection

Citation

Affonseca CA; Carvalho LFA; Quinet RPB; Guimaraes MCDC; Cury VF; Rotta AT, “Palliative extubation: five-year experience in a pediatric hospital,” Pediatric Palliative Care Library, accessed October 5, 2022, https://pedpalascnetlibrary.omeka.net/items/show/16526.

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