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Palliative Care Utilization Following Out-of-Hospital Cardiac Arrest in Pediatrics

Suzanne R Gouda1, Nicole L Bohr2,3, K Sarah Hoehn4

  • 1Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA.

Critical Care Explorations
|February 25, 2022
PubMed

Insights

Pediatric palliative care (PPC) is underutilized in out-of-hospital cardiac arrest (OHCA) cases despite high mortality. Further research is needed to explore automatic PPC consultations for eligible OHCA survivors.

Area of Science:

  • Pediatric Critical Care Medicine
  • Palliative Care
  • Emergency Medicine

Background:

  • Pediatric out-of-hospital cardiac arrest (OHCA) presents significant challenges in morbidity and mortality.
  • Pediatric palliative care (PPC) can offer crucial support to patients and families facing critical illness.

Purpose of the Study:

  • To examine the utilization of PPC services in children following OHCA.
  • To compare characteristics of children who received PPC versus those who did not.

Main Methods:

  • Retrospective cohort study of children (<21 years) admitted with OHCA to a tertiary PICU (October 2009-October 2019).
  • Inclusion criteria: OHCA diagnosis and minimum 48-hour PICU length of stay (LOS).
  • Data analyzed using descriptive statistics, Mann-Whitney U, and Fisher exact tests.

Main Results:

  • 34 of 118 eligible patients (28.8%) received PPC consultation.
  • PPC patients had longer PICU LOS (14.5 vs 4.0 days) and more ventilator days (12.5 vs 4.0 days).
  • Older age, longer LOS, and DNR status were associated with higher PPC utilization; mortality rates were similar between groups.

Conclusions:

  • PPC services are underutilized in pediatric OHCA cases.
  • Automatic PPC consultation for OHCA survivors beyond 48 hours warrants investigation.
  • Further research is needed to understand benefits and barriers of PPC integration in post-arrest care.
Abstract

Keywords:
cardiac arrestcritical care outcomesdo-not-resuscitategoals-of-care; palliative carepediatric intensive care unit

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