Toward interventions to improve end-of-life care in the pediatric intensive care unit

Area of Science:

• Pediatric critical care medicine
• Palliative care
• Family-centered care

Background:

• Children represent a small percentage of annual deaths but have unique end-of-life care needs.
• Existing research on interventions for end-of-life care in pediatric intensive care units (PICUs) is lacking.
• High-quality, family-centered care is crucial for pediatric patients nearing end-of-life.

Purpose of the Study:

• To review existing descriptive data on end-of-life care in PICUs.
• To identify critical domains for high-quality, family-centered care.
• To inform and facilitate future interventional studies.

Main Methods:

• Systematic review of descriptive data on end-of-life care in PICUs.
• Organization of data around six identified domains of family-centered care.
• Integration of data to develop evidence-based suggestions for interventions.

Main Results:

• Identified six critical domains: family support, communication, ethics/decision-making, symptom management, care continuity, and grief support.
• Highlighted the need for interventions tailored to the unique needs of children and their families.
• Provided a foundation for developing and evaluating interventions.

Conclusions:

• Evidence-based suggestions for interventions can improve end-of-life care in PICUs.
• Future research should focus on implementing and evaluating these interventions.
• Optimizing care for dying children in the PICU requires a comprehensive, family-centered approach.