Psychosocial Considerations for Cancer Patients in a Pediatric Intensive Care Unit at a Large, Freestanding Children’s Hospital

2018 ◽  
pp. 109-124
Author(s):  
Mara L. Leimanis ◽  
Sandra K. Zuiderveen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cancer Patients ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Children's Hospital ◽  
Children’S Hospital

scholarly journals Withdrawal of Treatment in a Pediatric Intensive Care Unit at a Children’s Hospital in China: A 10-year Retrospective Study

2020 ◽  
Author(s):  
Huaqing Liu ◽  
Dongni Su ◽  
Xubei Guo ◽  
Yunhong Dai ◽  
Xingqiang Dong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Interquartile Range ◽  
Published Data ◽  
Children's Hospital ◽  
Parental Decision Making ◽  
Withdrawal Of Treatment ◽  
Children’S Hospital

Abstract Background: Published data and practice recommendations on end-of-life care generally reflect Western practice frameworks; there are limited data on withdrawal of treatment for children in China. Methods: Withdrawal of treatment for children in the pediatric intensive care unit (PICU) of a regional children’s hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawal of treatment was categorized as medical withdrawal or premature withdrawal. The guardian’s self-reported reasons for abandoning the child’s treatment were recorded from 2011. Results: The incidence of withdrawal of treatment for children in the PICU decreased significantly; for premature withdrawal the 3-year average of 15.1% in 2006–2008 decreased to 1.9% in 2015–2017 (87.4% reduction). The overall incidence of withdrawal of care reduced over the time period, and withdrawal of therapy by guardians was the main contributor to the overall reduction. The median age of children for whom treatment was withdrawn increased from 14.5 months (interquartile range: 4.0–72.0) in 2006 to 40.5 months (interquartile range: 8.0–99.0) in 2017. Among the reasons given by guardians of children whose treatment was withdrawn in 2011–2017, “illness is too severe” ranked first, accounting for 66.3%, followed by “condition has been improved” (20.9%). Only a few guardians ascribed treatment withdrawal to economic reasons. Conclusions: The frequency of withdrawal of medical therapy has changed over time in this children’s hospital PICU, and parental decision-making has been a large part of the change.

scholarly journals Withdrawing treatment of Children in the pediatric intensive care unit of a China Children’s Hospital: A Single Center Years Retrospective Analysis

2020 ◽  
Author(s):  
Huaqing Liu ◽  
Dongni Su ◽  
Xubei Guo ◽  
Yunhong Dai ◽  
Xingqiang Dong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Eastern China ◽  
Pediatric Intensive Care ◽  
Interquartile Range ◽  
Published Data ◽  
Withdrawing Treatment ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract Background: Published data and practice recommendations on end-of-life generally reflect Western practice frameworks, there are few reports that refer to withdrawing treatment of children in China. Methods: Withdrawing treatment and reasons of children in the pediatric intensive care unit (PICU) of a regional children's hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawing treatment was divided into medical withdrawing and premature withdrawing as defined. Results: The incidence of withdrawing treatment among children in the PICU decreased significantly, for premature withdrawing from a 3-year average of 15.1% in 2006–2008 to 1.9% in 2015–2017 (87.4% reduction). The decrease in cases of premature withdrawing contributed most of the decrease in total withdrawing. The median age of children in whom treatment was withdrawn increased from 14.5 (interquartile range: 4.0–72.0) months in 2006 to 40.5 (interquartile range: 8.0– 99.0) months in 2017. Reasons given by guardians of children whose treatments were withdrawn in 2011–2017, “illness is too severe” ranked first, accounting for 66.3%, followed by “condition has been improved” (20.9%). Only a few of the guardians ascribed withdrawing treatment to economic reasons. Conclusions: The decreasing in incidence of withdrawing treatment and an increase in the age of children whose treatment was withdrawn show that guardians are more willing to actively treat their children in this children’s hospital during the last years. Chinese children's guardians have their own unique ways of expression when self-reported reasons for withdrawing treatment.

scholarly journals Withdrawal of Treatment in a Pediatric Intensive Care Unit at a Children’s Hospital in China: A 10-year Retrospective Study

2020 ◽  
Author(s):  
Huaqing Liu ◽  
Dongni Su ◽  
Xubei Guo ◽  
Yunhong Dai ◽  
Xingqiang Dong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Interquartile Range ◽  
Published Data ◽  
Withdrawing Treatment ◽  
Children's Hospital ◽  
Parental Decision Making ◽  
Children’S Hospital

Abstract Background: Published data and practice recommendations on end-of-life care generally reflect Western practice frameworks; there are limited data that refer to withdrawing treatment of children in China. Methods: Withdrawing treatment of children in the pediatric intensive care unit (PICU) of a regional children’s hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawing treatment was divided into medical withdrawal and premature withdrawal as defined. The guardian’s self-reported reasons for abandoning the child’s treatment were recorded from 2011.Results: The incidence of withdrawing treatment from children in the PICU decreased significantly, for premature withdrawal, from a 3-year average of 15.1% in 2006–2008 to 1.9% in 2015–2017 (87.4% reduction). The overall incidence of withdrawal of care reduced over the time period, and withdrawal of therapy by guardians was the main contributor to the overall reduction. The median age of children from whom treatment was withdrawn increased from 14.5 (interquartile range: 4.0–72.0) months in 2006 to 40.5 (interquartile range: 8.0–99.0) months in 2017. Among the reasons given by guardians of children whose treatments were withdrawn in 2011–2017, “illness is too severe” ranked first, accounting for 66.3%, followed by “condition has been improved” (20.9%). Only a few of the guardians ascribed withdrawing treatment to economic reasons.Conclusions: The frequency of withdrawal of medical therapy has changed over time in this children’s hospital PICU, and parental decision-making has been a large part of the change.

scholarly journals Withdrawal of Treatment in Pediatric Intensive Care Unit at a Children's Hospital of China: a Period of 10 Years Retrospective Study

2020 ◽  
Author(s):  
Huaqing Liu ◽  
Dongni Su ◽  
Xubei Guo ◽  
Yunhong Dai ◽  
Xingqiang Dong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Eastern China ◽  
Pediatric Intensive Care ◽  
Interquartile Range ◽  
Published Data ◽  
Withdrawing Treatment ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract Background: Published data and practice recommendations on end-of-life generally reflect Western practice frameworks, there are few reports that refer to withdrawing treatment of children in China. Methods: Withdrawing treatment and reasons of children in the pediatric intensive care unit (PICU) of a regional children's hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawing treatment was divided into medical withdrawing and premature withdrawing as defined.Results: The incidence of withdrawing treatment among children in the PICU decreased significantly, for premature withdrawing from a 3-year average of 15.1% in 2006–2008 to 1.9% in 2015–2017 (87.4% reduction). Overall incidence of withdrawal of care reduced over the time period, and withdrawal of therapy by guardians was the main contributor to the overall reduction. The median age of children in whom treatment was withdrawn increased from 14.5 (interquartile range: 4.0-72.0) months in 2006 to 40.5 (interquartile range: 8.0– 99.0) months in 2017. Reasons given by guardians of children whose treatments were withdrawn in 2011-2017, “illness is too severe” ranked first, accounting for 66.3%, followed by “condition has been improved” (20.9%). Only a few of the guardians ascribed withdrawing treatment to economic reasons.Conclusions: The decreasing in incidence of premature withdrawing suggests that guardians are more willing to actively treat their children in this children’s hospital during the last years. Chinese children's guardians have their own unique ways of expression when self-reported reasons for withdrawing treatment.

scholarly journals Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt

2014 ◽  
Vol 8 (05) ◽  
pp. 624-634 ◽  
Author(s):  
Moustafa Hegazi ◽  
Alaa Abdelkader ◽  
Maysaa Zaki ◽  
Basem El-Deek
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Amphotericin B ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Attributable Mortality ◽  
Candida Colonization ◽  
Children's Hospital ◽  
Children’S Hospital

Introduction: This study was conducted to determine characteristics of Candida colonization and candidemia in the pediatric intensive care unit (PICU) of a tertiary care children's hospital. Methodology: Patients between 6 months and 15 years of age consecutively admitted to the PICU of Mansoura University Children’s Hospital in Mansoura, Egypt, during one year period, were evaluated for Candida colonization and candidemia. Susceptibility of Candida species isolated from blood to fluconazole and amphotericin B was determined by Etest. Results: Sixty-six patients without prior fluconazole prophylaxis had 88 episodes of candidemia, representing 19% of all cases with blood stream infections (BSIs).  Candida albicans (CA) and non-albicans Candida (NAC) species accounted for 40% and 60% of candidemia episodes respectively. C. parapsilosis, C. tropicalis, and C. glabrata accounted for 25%, 17%, and 8% of NAC candidemias respectively. Fluconazole resistance was detected in 11.4% and 18.9% of CA and NAC isolates respectively. Of the fluconazole resistant NAC isolates, four were C. krusei. Amphotericin B resistance was detected in 17% of NAC isolates. Candida colonization was detected in 78.8% of patients. Compared to CA candidemia, higher risk for NAC candidemia was associated with age older than 1 year, Candida isolation from endotracheal tube (ETT) and from central venous catheter. Mortality rate was 42.4%, attributable mortality of candidemia was 16.7%. Regression analysis showed that the most significant independent predictors of death were ETT and mechanical ventilation (MV), MV longer than 7 days, and candiduria. Conclusions: This study presents important epidemiological features of Candida BSIs in a non-neonatal population.

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