End-of-life practices in seven Brazilian pediatric intensive care units

Detalhes bibliográficos
Autor(a) principal: Lago, Patricia M.
Data de Publicação: 2008
Outros Autores: Piva, Jefferson, Garcia, Pedro Celiny, Troster, Eduardo, Bousso, Albert, Sarno, Maria Olivia, Torreão, Lara de Araújo, Sapolnik, Roberto
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da UFBA
Texto Completo: http://repositorio.ufba.br/ri/handle/ri/14303
Resumo: Texto completo: acesso restrito. p. 26-31
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spelling Lago, Patricia M.Piva, JeffersonGarcia, Pedro CelinyTroster, EduardoBousso, AlbertSarno, Maria OliviaTorreão, Lara de AraújoSapolnik, RobertoLago, Patricia M.Piva, JeffersonGarcia, Pedro CelinyTroster, EduardoBousso, AlbertSarno, Maria OliviaTorreão, Lara de AraújoSapolnik, Roberto2014-01-08T16:41:42Z20081529-7535http://repositorio.ufba.br/ri/handle/ri/14303v. 9, n. 1Texto completo: acesso restrito. p. 26-31Objective: To evaluate the incidence of life support limitation and medical practices in the last 48 hrs of life of c in seven Brazilian pediatric intensive care units (PICUs). Design: Cross-sectional multicenter retrospective study based on medical chart review. Setting: Seven PICUs belonging to university and tertiary hospitals located in three Brazilian regions: two in Porto Alegre (southern region), two in São Paulo (southeastern region), and three in Salvador (northeastern region). Patients: Medical records of all children who died in seven PICUs from January 2003 to December 2004. Deaths in the first 24 hrs of admission to the PICU and brain death were excluded. Interventions: Two pediatric intensive care residents from each PICU were trained to fill out a standard protocol ([kappa] = 0.9) to record demographic data and all medical management provided in the last 48 hrs of life (inotropes, sedatives, mechanical ventilation, full resuscitation maneuvers or not). Student's t-test, analysis of variance, chi-square test, and relative risk were used for comparison of data. Measurements and Main Results: Five hundred and sixty-one deaths were identified; 97 records were excluded (61 because of brain death and 36 due to <24 hrs in the PICU). Thirty-six medical charts could not be found. Cardiopulmonary resuscitation was performed in 242 children (57%) with a significant difference between the southeastern and northeastern regions (p = .0003). Older age (p = .025) and longer PICU stay (p = .001) were associated with do-not-resuscitate orders. In just 52.5% of the patients with life support limitation, the decision was clearly recorded in the medical chart. No ventilatory support was provided in 14 cases. Inotropic drug infusions were maintained or increased in 66% of patients with do-not-resuscitate orders. Conclusions: The incidence of life support limitation has increased among Brazilian PICUs but with significant regional differences. Do-not-resuscitate orders are still the most common practice, with scarce initiatives for withdrawing or withholding life support measures.Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-12-17T10:31:00Z No. of bitstreams: 1 00130478-200801000-00006.pdf: 262144 bytes, checksum: cc5056e5e553ff99a0f7cae116ea0f9b (MD5)Approved for entry into archive by Flávia Ferreira (flaviaccf@yahoo.com.br) on 2014-01-08T16:41:42Z (GMT) No. of bitstreams: 1 00130478-200801000-00006.pdf: 262144 bytes, checksum: cc5056e5e553ff99a0f7cae116ea0f9b (MD5)Made available in DSpace on 2014-01-08T16:41:42Z (GMT). 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dc.title.pt_BR.fl_str_mv End-of-life practices in seven Brazilian pediatric intensive care units
dc.title.alternative.pt_BR.fl_str_mv Pediatric Critical Care Medicine
title End-of-life practices in seven Brazilian pediatric intensive care units
spellingShingle End-of-life practices in seven Brazilian pediatric intensive care units
Lago, Patricia M.
Pediatrics
Intensive Care
Intensive Care Units - Pediatric
title_short End-of-life practices in seven Brazilian pediatric intensive care units
title_full End-of-life practices in seven Brazilian pediatric intensive care units
title_fullStr End-of-life practices in seven Brazilian pediatric intensive care units
title_full_unstemmed End-of-life practices in seven Brazilian pediatric intensive care units
title_sort End-of-life practices in seven Brazilian pediatric intensive care units
author Lago, Patricia M.
author_facet Lago, Patricia M.
Piva, Jefferson
Garcia, Pedro Celiny
Troster, Eduardo
Bousso, Albert
Sarno, Maria Olivia
Torreão, Lara de Araújo
Sapolnik, Roberto
author_role author
author2 Piva, Jefferson
Garcia, Pedro Celiny
Troster, Eduardo
Bousso, Albert
Sarno, Maria Olivia
Torreão, Lara de Araújo
Sapolnik, Roberto
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Lago, Patricia M.
Piva, Jefferson
Garcia, Pedro Celiny
Troster, Eduardo
Bousso, Albert
Sarno, Maria Olivia
Torreão, Lara de Araújo
Sapolnik, Roberto
Lago, Patricia M.
Piva, Jefferson
Garcia, Pedro Celiny
Troster, Eduardo
Bousso, Albert
Sarno, Maria Olivia
Torreão, Lara de Araújo
Sapolnik, Roberto
dc.subject.por.fl_str_mv Pediatrics
Intensive Care
Intensive Care Units - Pediatric
topic Pediatrics
Intensive Care
Intensive Care Units - Pediatric
description Texto completo: acesso restrito. p. 26-31
publishDate 2008
dc.date.issued.fl_str_mv 2008
dc.date.accessioned.fl_str_mv 2014-01-08T16:41:42Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://repositorio.ufba.br/ri/handle/ri/14303
dc.identifier.issn.none.fl_str_mv 1529-7535
dc.identifier.number.pt_BR.fl_str_mv v. 9, n. 1
identifier_str_mv 1529-7535
v. 9, n. 1
url http://repositorio.ufba.br/ri/handle/ri/14303
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.source.pt_BR.fl_str_mv http://dx.doi.org/10.1097/01.PCC.0000298654.92048.BD
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