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
Identifier
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
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Citation List Month
November 2019 List
URL Address
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 April 19, 2024, https://pedpalascnetlibrary.omeka.net/items/show/16526.