Related Experiment Video

Updated: Dec 27, 2025

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
11:27

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

7.1K

Palliative Care in Children With Heart Disease Treated in an ICU

Claudia Delgado-Corcoran1, Sarah E Wawrzynski2, Erin E Bennett1

  • 1Division of Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|March 7, 2020
PubMed

Insights

Pediatric palliative care consultations are infrequent in pediatric cardiac ICUs, despite high patient complexity and mortality. Consults improved end-of-life care, but many eligible patients were not referred.

Area of Science:

  • Pediatric Cardiology
  • Palliative Care
  • Healthcare Quality Improvement

Background:

  • Pediatric palliative care (PPC) is crucial for children with complex chronic conditions, particularly those with heart disease.
  • Understanding the utilization and impact of PPC consults in pediatric cardiac intensive care units (CICUs) is essential for improving end-of-life care.

Purpose of the Study:

  • To describe PPC consults in children with heart disease admitted to a CICU.
  • To assess the impact of PPC on end-of-life care outcomes.
  • To evaluate adherence to established PPC referral criteria.

Main Methods:

  • Retrospective single-center study of children (0-21 years) with heart disease admitted to a CICU from January 2014 to June 2017.
  • Analysis of patient characteristics, consult rates, and end-of-life outcomes.
  • Application of Center to Advance Palliative Care (CAPC) criteria to identify eligible patients.

Main Results:

  • Of 1,389 patients, only 8% (112) received a PPC consult. Patients receiving consults were younger, had more complex conditions, longer ICU stays, and higher mortality (38% vs 3%).
  • PPC consults were associated with increased comfort care at end-of-life (36% vs 2%) and higher rates of death at home (24% vs 2%).
  • CAPC criteria identified 158 eligible patients, but only 19% (30) received a consult, indicating significant missed referrals.

Conclusions:

  • PPC consults are underutilized in CICUs, despite serving a medically complex and high-mortality population.
  • PPC positively impacts end-of-life care, facilitating comfort and home deaths.
  • There is a substantial gap between recommended PPC eligibility and actual consultation rates, highlighting a need for improved referral processes.
Abstract

More Related Videos

Implantation of Total Artificial Heart in Congenital Heart Disease07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

25.0K
Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model04:55

Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model

Published on: May 26, 2023

1.2K

Related Concept Videos

Continuing Care01:25

Continuing Care

Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
1.8K
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
246
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
193
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
361
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
174
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
351