停止维持生命治疗后的儿童死亡:一个范围广泛的审查

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Conall Francoeur¹, Amina Silva², Laura Hornby³

¹Division of Pediatric Critical Care, Department of Pediatrics, McGill University, Montreal, QC, Canada.

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

|September 7, 2023

概括

在停止维持生命措施 (WLSM) 后,儿童的死亡过程尚不清楚. 改善WLSM后死亡时间预测可以增强对家庭和医疗保健团队的护理和支持.

科学领域:

儿科重症监护医药儿科重症监护医药
息治疗和终身护理
生物伦理学生物伦理学

背景情况:

在儿科重症监护室 (PICU) 停止维持生命措施 (WLSM) 后,儿童的死亡过程是复杂的,研究不足的.
现有的文献缺乏对生理方面的全面理解,对死亡时间的预测,以及对家庭和医疗保健专业人员的深刻影响.

研究的目的:

系统地评估现有的关于在PICU中WLSM后儿童死亡过程的文献.
探索死亡的生理学,死亡时间的可预测性,以及对家庭和医疗保健工作者的心理影响.
确定对器官捐献和未来研究优先事项的影响.

主要方法:

在多个数据库 (MEDLINE,Embase,Cochrane,PsycINFO,CINAHL,Web of Science) 中进行了全面的文献搜索.
纳入了专注于在PICU中WLSM后死亡过程的研究,没有日期或研究类型的限制.
使用诱导性的定性内容分析来综合包括在内的24项研究的发现.

主要成果:

很少有有效的工具可以预测儿童在WLSM后死亡的时间;大多数死亡发生在一小时内.
死亡过程的不可预测性给家庭和医疗保健提供者带来了重大的情感挑战和压力.
围绕死亡时间的不确定性会对家庭考虑器官捐献的可能性产生负面影响.

结论:

在儿科重症监护中死亡过程的理解不足,使家庭和临床团队没有足够的支持工具.
提高WLSM后死亡时间的预测对于改善终身护理提供至关重要.
更好的理解和预测可以为患者,家庭和医疗保健专业人员提供更好的支持,并可能增加器官捐赠者的识别.

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