Palliative extubation: five-year experience in a pediatric hospital

Area of Science:

• Pediatric critical care medicine
• Palliative care
• Respiratory medicine

Background:

• Chronic and irreversible diseases in children often necessitate long-term mechanical ventilation.
• Palliative extubation is a procedure for children with terminal conditions to withdraw ventilatory support.

Purpose of the Study:

• To characterize pediatric patients undergoing palliative extubation.
• To describe patient demographics, diagnoses, and outcomes.

Main Methods:

• Descriptive analysis of 19 pediatric patients.
• Data collected from medical records (April 2014 - May 2019).
• Included demographics, ventilation details, extubation specifics, medications, symptoms, and outcomes.

Main Results:

• Mean age 2.2 years; 57.9% died in-hospital.
• Extubations primarily in the ICU (68.4%).
• Common symptoms: dyspnea and pain, managed with opioids and benzodiazepines.

Conclusions:

• No predictors of in-hospital death were identified.
• Palliative extubation necessitates specialized, multidisciplinary team care.
• Adequate training in symptom control and palliative care is crucial.