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Paediatric death after withdrawal of life-sustaining therapies: a scoping review protocol
Conall Francoeur1, Laura Hornby2, Amina Silva3
1Department of Pediatrics, Centre de recherche du CHU de Quebec-Universite Laval, Quebec, Quebec, Canada Conall.Francoeur.med@ssss.gouv.qc.ca.
Insights
Understanding the dying process in children after withdrawal of life-sustaining measures (WLSM) is crucial. This review synthesizes current knowledge on pediatric end-of-life care and organ donation after WLSM.
Area of Science:
- Pediatric critical care medicine
- Palliative care
- End-of-life studies
Background:
- The physiology of dying after withdrawal of life-sustaining measures (WLSM) in children is poorly understood.
- This knowledge gap hinders accurate prediction of the dying process duration.
- Uncertainty impacts family planning, emotional well-being, and end-of-life care decisions.
Purpose of the Study:
- To conduct a scoping review of the literature on the dying process in children following WLSM.
- To summarize current knowledge regarding the physiology and timing of death in pediatric intensive care units (PICUs).
- To explore the implications of timing and prediction on families and organ donation.
Main Methods:
- Utilizing Joanna Briggs Institute methodology for scoping reviews.
- Comprehensive search of multiple electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science).
- Inclusion of quantitative and qualitative studies on pediatric dying post-WLSM, prediction tools, and family/donation impacts.
Main Results:
- This section is to be populated upon completion of the review.
- Anticipated synthesis of existing literature on pediatric dying physiology.
- Expected identification of factors influencing time-to-death and its consequences.
Conclusions:
- This review will provide a comprehensive overview of the dying process in children after WLSM.
- Findings will inform clinical practice, family support, and organ donation protocols.
- Enhanced understanding is vital for improving end-of-life care in pediatric intensive care settings.
Introduction:
The physiology of dying after withdrawal of life-sustaining measures (WLSM) is not well described in children. This lack of knowledge makes predicting the duration of the dying process difficult. For families, not knowing this process's duration interferes with planning of rituals related to dying, travel for distant relatives and emotional strain during the wait for death. Time-to-death also impacts end-of-life care and determines whether a child will be eligible for donation after circulatory determination of death. This scoping review will summarise the current literature about what is known about the dying process in children after WLSM in paediatric intensive care units (PICUs).
Methods And Analysis:
This review will use Joanna Briggs Institute methodology for scoping reviews. Databases searched will include Ovid MEDLINE, Ovid Embase, Cochrane Central Register of Controlled Trials via EBM Reviews Ovid, Ovid PsycINFO, CINAHL and Web of Science. Literature reporting on the physiology of dying process after WLSM, or tools that predict time of death in children after WLSM among children aged 0-18 years in PICUs worldwide will be considered. Literature describing the impact of prediction or timing of death after WLSM on families, healthcare workers and the organ donation process will also be included. Quantitative and qualitative studies will be evaluated. Two independent reviewers will screen references by title and abstract, and then by full text, and complete data extraction and analysis.
Ethics And Dissemination:
The review uses published data and does not require ethics review. Review results will be published in a peer-reviewed scientific journal.
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