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Intensive Care Medicine

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01-11-2011 | Legal and Ethical Issues

Forgoing life support: how the decision is made in European pediatric intensive care units

Authors: Denis J. Devictor, Jos M. Latour, the EURYDICE II study group

Published in: Intensive Care Medicine | Issue 11/2011

Abstract

Purpose

To determine how decisions to forgo life support are made in European pediatric intensive care units (PICUs).

Methods

A multicenter, prospective study, the Eurydice II study, among 45 PICUs: 20 in France, 21 in Northern/Western (N/W) European countries, and 4 in Eastern/Central (E/C) Europe. Data were collected between November 2009 and April 2010 through a questionnaire.

Results

The decision to forgo life-sustaining treatment was made in 166 (40.6%) out of 409 deceased children (median 42.9%, France 38.2%, N/W European countries 60.0%, E/C European countries 0%; P < 0.001). In the E/C group, more patients died after cardiopulmonary resuscitation (CPR) failure than after forgoing life support (P < 0.001). In all PICUs, caregivers discussed the decision during a formal meeting, after which the medical staff made the final decision. The decision was often documented in the medical record (median 100%). The majority of the parents were informed of the final decision and were at the bedside during their child’s death (median 100%). Decision to forgo life-sustaining treatment occurred in 40.6% of children, compared with 33% in Eurydice I. A high percentage of parents from France were now informed about the meeting and its conclusion as compared with Eurydice I (median 100%).

Conclusions

The results of this study and comparison with the Eurydice I study (2002) show a trend towards standardization of end-of-life practices across N/W European countries and France in the past decade.

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Title: Forgoing life support: how the decision is made in European pediatric intensive care units
Authors: Denis J. Devictor
Jos M. Latour
the EURYDICE II study group
Publication date: 01-11-2011
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 11/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-011-2357-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Forgoing life support: how the decision is made in European pediatric intensive care units

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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