导航关于儿童停止ECLS治疗的生命终结决策:来自国际ENSURE调查的见解
Angelo Polito1, Marcel Fleig2, Janet Kelly-Geyer3
1Paediatric Intensive Care Unit, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospital, Geneva University of Medicine, Geneva, Switzerland.
European journal of pediatrics
|December 1, 2025
概括
儿童体外生命支持 (ECLS) 退出决定在欧洲因地区和宗教而异. 需要标准化的指导方针和伦理咨询,以支持医疗保健专业人员并减少道德困境.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 医学伦理 医学伦理
- 医疗保健专业人员的福祉
背景情况:
- 儿童体外生命支持 (ECLS) 退出决定涉及家庭,并受到情绪因素的影响.
- 关于儿科ECLS伦理的文献有限,具体建议很少.
研究的目的:
- 调查欧洲医疗保健专业人员对儿科ECLS停药的看法.
- 探索文化,宗教和区域因素对ECLS决策的影响.
- 为医疗保健专业人员确定改善支持和指导方针的需求.
主要方法:
- 在21个欧洲国家进行了一项23项混合方法问卷调查 (ENSURE研究).
- 该调查评估了受访者的人口统计数据,伦理观点和与儿科ECLS相关的机构实践.
- 分析的重点是基于地理区域,职业和宗教的决策差异.
主要成果:
- 192名医疗保健专业人员参加;68%来自体外生命支持组织 (ELSO) 中心.
- 77%的人同意,当ECLS的目标未实现时,伦理咨询会使患者和家人受益.
- 对停止ECLS的偏好因地区而异;北欧/西欧更喜欢舒适护理 (62-68%) 比南欧/东欧 (34-50%).
- 基督徒和不可知论者/无神论者参与者更有可能支持停止ECLS治疗.
结论:
- 儿科ECLS停药决定受到区域,文化和宗教因素的影响.
- 标准化的指导方针和更多的伦理咨询是必要的,以支持临床医生和减轻道德困扰.
- 解决临床团队的不和,改善息护理的准入,可以提高决策和患者的结果.
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