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Critical Situations in Children, Adolescents and Young Adults with Terminal Cancer within the Home Setting

M Kuhlen1, S Balzer1, C Friedland1

  • 1Department of Paediatric Oncology, Haematology and Clinical Immunology, Center for Child and Adolescent Health, Heinrich Heine University, Duesseldorf, Germany.

Klinische Padiatrie
|March 27, 2015
PubMed

Insights

Pediatric palliative care teams can reduce distressing critical situations (CS) in children with terminal cancer through advanced planning and support. Most CS are manageable at home, focusing on the child's symptoms and family needs.

Area of Science:

  • Pediatric Oncology
  • Palliative Care
  • Symptom Management

Background:

  • Children with terminal cancer may experience distressing critical situations (CS) near end-of-life.
  • These situations cause significant distress for both the child and their caregivers.

Purpose of the Study:

  • To analyze the occurrence and characteristics of critical situations (CS) in children with terminal cancer.
  • To identify factors influencing CS and evaluate management strategies.

Main Methods:

  • Retrospective analysis of 133 children managed by a pediatric palliative care team (PPCT) from 1998-2009.
  • Defined CS as a life-threatening or acutely frightening deterioration due to a symptom.

Main Results:

  • 45 CS occurred in 38 (28.6%) children, predominantly in the final week of life.
  • Neurological symptoms were the leading cause; most CS (88.9%) were managed at home.
  • Two-thirds of CS were anticipated, yet required intervention or PPCT support.

Conclusions:

  • Advanced planning, communication, and 24-h support can minimize CS in pediatric cancer patients.
  • Effective management of CS involves addressing symptoms and wishes of the child and family.
  • Focusing on conditions like status epilepticus and dyspnea is crucial in palliative care.
Abstract

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