Dying in the intensive care unit: Collaborative multicenter study about forgoing life-sustaining treatment in Argentine pediatric intensive care units*

2003 ◽  
Vol 4 (2) ◽  
pp. 164-169 ◽  
Author(s):  
Mar??a Althabe ◽  
Gustavo Cardigni ◽  
Juan C. Vassallo ◽  
Daniel Allende ◽  
Mabel Berrueta ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Multicenter Study ◽  
Pediatric Intensive Care ◽  
Pediatric Intensive Care Units ◽  
Life Sustaining Treatment

Forgoing life-sustaining treatment in three pediatric intensive care units in southern Brazil

2005 ◽  
Vol 6 (1) ◽  
pp. 119
Author(s):  
Patricia M. Lago ◽  
Jefferson Piva ◽  
D??lio Kipper ◽  
Pedro C. Garcia ◽  
Cristiane Pretto ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care ◽  
Southern Brazil ◽  
Pediatric Intensive Care Units ◽  
Life Sustaining Treatment

Living with Dying in the Pediatric Intensive Care Unit: A Nursing Perspective

2016 ◽  
Vol 25 (4) ◽  
pp. 350-356 ◽  
Author(s):  
Debbie Stayer ◽  
Joan Such Lockhart
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Emotional Impact ◽  
Pediatric Intensive Care Units ◽  
Personal Support ◽  
Life Threatening

Background Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units. Objectives To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children’s families. Methods A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences. Results Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child’s death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support. Conclusion Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children’s families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying.

scholarly journals Impact of the French National Lockdown on Admissions to 14 Pediatric Intensive Care Units During the 2020 COVID-19 Pandemic–A Retrospective Multicenter Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Sophie Breinig ◽  
Guillaume Mortamet ◽  
David Brossier ◽  
Romain Amadieu ◽  
Isabelle Claudet ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Multicenter Study ◽  
Pediatric Intensive Care ◽  
National Database ◽  
National Study ◽  
Main Diagnosis ◽  
Pediatric Intensive Care Units ◽  
Hospital Funding ◽  
Retrospective Multicenter Study

Background: After the COVID-19 pandemic reached France in January 2020, a national lockdown including school closures was officially imposed from March 17, 2020, to May 10, 2020. Pediatric intensive care units (PICUs) admit critically ill infants, children and teenagers with severe acute conditions, in particular infectious and traumatic diseases. We hypothesized that PICU admissions would be considerably modified by the lockdown.Aims: The objectives of the study were to describe the type of admissions to French PICUs and to compare the occupation of PICU beds according to local epidemic conditions during the French national lockdown period, compared with the same period the previous year.Methods: We conducted a retrospective multicenter study in 14 French PICUs. All children aged from 7 days to 18 years admitted to one of the 14 participating PICUs over two 3-month period (March 1, 2020, to May 31, 2020 and March 1, 2019, to May 31, 2019) were included. Analysis was based on data extracted from the medicalized information systems program (a national database used in all French hospitals, into which all admissions and their diagnoses are coded for the purpose of calculating hospital funding). Each main diagnosis was reclassified in 13 categories, corresponding to normal PICU admissions.Results: We analyzed a total of 3,040 admissions, 1,323 during the 2020 study period and 1,717 during the same period in 2019. Total admissions decreased by 23% [incidence rate ratio (IRR) 0.77, 95% CI 0.71–0.83, p < 0.001], in particular for viral respiratory infections (−36%, IRR 0.64, 95% CI 0.44–0.94, p = 0.001). Admissions for almost all other diagnostic categories decreased, except intoxications and diabetes which increased, while admissions for cardiac and hemodynamic disorders were stable. Patient age and the sex ratio did not differ between the two periods. Median length of stay in the PICU was longer in 2020 [4 (IQR 2–9) vs. 3 (IQR 1–8) days, p = 0.002] in 2019. Mortality remained stable.Conclusions: In this large national study, we showed a decrease in the number of PICU admissions. The most severe patients were still admitted to intensive care and overall mortality remained stable.

scholarly journals Clinical significance of potential drug–drug interactions in a pediatric intensive care unit: A single-center retrospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246754
Author(s):  
Yu Hyeon Choi ◽  
In Hwa Lee ◽  
Mihee Yang ◽  
Yoon Sook Cho ◽  
Yun Hee Jo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Drug Interactions ◽  
Intensive Care Units ◽  
Pediatric Intensive Care Unit ◽  
Clinical Relevance ◽  
Pediatric Intensive Care ◽  
Adverse Outcomes ◽  
Potential Drug ◽  
Pediatric Intensive Care Units

Despite the high prevalence of potential drug–drug interactions in pediatric intensive care units, their clinical relevance and significance are unclear. We assessed the characteristics and risk factors of clinically relevant potential drug–drug interactions to facilitate their efficient monitoring in pediatric intensive care units. This retrospective cohort study reviewed the medical records of 159 patients aged <19 years who were hospitalized in the pediatric intensive care unit at Seoul National University Hospital (Seoul, Korea) for ≥3 days between August 2019 and February 2020. Potential drug–drug interactions were screened using the Micromedex Drug-Reax® system. Clinical relevance of each potential drug–drug interaction was reported with official terminology, magnitude of severity, and causality, and the association with the patient’s clinical characteristics was assessed. In total, 115 patients (72.3%) were exposed to 592 potential interactions of 258 drug pairs. In 16 patients (10.1%), 22 clinically relevant potential drug–drug interactions were identified for 19 drug pairs. Approximately 70% of the clinically relevant potential drug–drug interactions had a severity grade of ≥3. Exposure to potential drug–drug interactions was significantly associated with an increase in the number of administrated medications (6–7 medications, p = 0.006; ≥8, p<0.001) and prolonged hospital stays (1–2 weeks, p = 0.035; ≥2, p = 0.049). Moreover, clinically relevant potential drug–drug interactions were significantly associated with ≥8 prescribed drugs (p = 0.019), hospitalization for ≥2 weeks (p = 0.048), and ≥4 complex chronic conditions (p = 0.015). Most potential drug–drug interactions do not cause clinically relevant adverse outcomes in pediatric intensive care units. However, because the reactions that patients experience from clinically relevant potential drug–drug interactions are often very severe, there is a medical need to implement an appropriate monitoring system for potential drug–drug interactions according to the pediatric intensive care unit characteristics.

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