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Learning From Investigation After Death.

Benedict T Griffiths1, Neil J Sebire2, Joe Brierley1

  • 1Paediatric & Neonatal Intensive Care, Great Ormond St Hospital, London, United Kingdom.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|August 7, 2018
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Summary
This summary is machine-generated.

Postmortem examinations in pediatric intensive care units (PICUs) offer vital clinical information, even with advanced diagnostics. Open communication between PICU and pathology teams is crucial for informing bereaved families about these investigations.

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Area of Science:

  • Forensic Pathology
  • Pediatric Critical Care Medicine
  • Medical Ethics

Background:

  • Traditional postmortem examinations are underutilized due to family acceptability and perceived limited utility.
  • Despite advancements in diagnostic techniques, postmortem examinations remain a critical tool for obtaining clinically relevant information.
  • This review focuses on postmortem examinations for children who die in the pediatric intensive care unit (PICU), including both consented and legally mandated cases.

Purpose of the Study:

  • To review the utility and acceptability of postmortem examinations for children in the PICU.
  • To explore how postmortem investigations can provide valuable information to bereaved families and clinicians.
  • To examine newer technologies in postmortem examination and their potential impact on family acceptance.

Main Methods:

  • A comprehensive literature review was conducted.
  • Included are journal articles detailing practices in pediatric and adult postmortem examinations.

Main Results:

  • Postmortem examinations consistently yield clinically relevant data, underscoring their importance.
  • Newer techniques like postmortem imaging and minimally invasive tissue sampling show promise for increased family acceptance.
  • Widespread acceptance of these newer techniques as equivalent to standard methods by forensic services is still pending.

Conclusions:

  • PICU teams must proactively inform bereaved parents about available postmortem investigations, including legal mandates.
  • Compassionate and thorough discussions involving pathology and clinical specialists are essential to explain procedures, timelines, and results.
  • Clear communication regarding the availability of the child's body and tissues for funeral arrangements is vital.