Approximately two-thirds of children and young people who die in paediatric intensive care units (PICU) do so following withdrawal of intensive care treatment. Most often, these children remain in PICU for end of life care. This study examined the process of referral over a 6 year period from a PICU to children's hospices for end of life care. During this time period, a total of 12 children were transferred, with a third of children transported to the hospice while still dependant on ventilatory support. All children were extubated by a PICU consultant within 90 minutes of arrival at the hospice. Overall, 8 children died sooner after transfer, with four children surviving beyond 2 weeks after transfer. The study suggests there is a feasible alternative location for withdrawal of intensive care and/or compassionate extubation and has led to the creation of a national care pathway to support extubation within a children's palliative care framework.
Gupta, N., Harrop, E., Lapwood, S. & Shefler, A. 2013. Journey from pediatric intensive care to palliative care. Journal of Palliative Medicine, 16 (4) p 397-401.
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