A Framework for Pediatric Intensivists Providing Compassionate Extubation at Home*

Woodruff, Alan G.; Bingham, Sarah; Jarrah, Rima J.; Bass, Andora L; Nageswaran, Savithri

doi:10.1097/pcc.0000000000002655

Cited by 7 publications

(26 citation statements)

References 25 publications

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“…Despite being resource intensive and logistically challenging, reports have reaffirmed the feasibility of CEAH in the pediatric population with positive outcomes (51,52). A recently published framework detailing processes from preparation to follow through acts as a good reference for PICU intensivists in their provision of CEAH as an option of EOL care (53).…”

Section: Withdrawal Withholding Of Life Sustaining Therapy or Non-esc...mentioning

confidence: 99%

Palliative and Critical Care: Their Convergence in the Pediatric Intensive Care Unit

et al. 2022

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Palliative care (PC) is an integral component of optimal critical care (CC) practice for pediatric patients facing life-threatening illness. PC acts as an additional resource for patients and families as they navigate through critical illness. Although PC encompasses end of life care, it is most effective when integrated early alongside disease-directed and curative therapies. PC primarily focuses on improving quality of life for patients and families by anticipating, preventing and treating suffering throughout the continuum of illness. This includes addressing symptom distress and facilitating communication. Effective communication is vital to elicit value-based goals of care, and to guide parents through patient-focused and potentially difficult decision-making process which includes advanced care planning. A multidisciplinary approach is most favorable when providing support to both patient and family, whether it is from the psychosocial, practical, emotional, spiritual or cultural aspects. PC also ensures coordination and continuity of care across different care settings. Support for family carries on after death with grief and bereavement support. This narrative review aims to appraise the current evidence of integration of PC into pediatric CC and its impact on patient- and family-centered outcomes. We will also summarize the impact of integration of good PC into pediatric CC, including effective communication with families, advanced care planning, withholding or withdrawal of life sustaining measures and bereavement support. Finally, we will provide a framework on how best to integrate PC in PICU. These findings will provide insights on how PC can improve the quality of care of a critically ill child.

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Section: Withdrawal Withholding Of Life Sustaining Therapy or Non-esc...mentioning

confidence: 99%

Palliative and Critical Care: Their Convergence in the Pediatric Intensive Care Unit

et al. 2022

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“…Transfer for home/other WLST should always occur as part of overall excellent holistic end-of-life planning. The checklist (Table 2) in the article by Woodruff et al (7) will be helpful for PIC teams, which can factor in specific local issues in developing their own systems to provide this service. It reminds us that organ donation decisions, which cannot occur after a transfer and tissue donation, which can, must be made before CEAH.…”

Section: Crucial Considerationsmentioning

confidence: 99%

“…As the article by Woodruff et al (7) quite rightly highlights, it is the duty of the PIC team working with colleagues to ensure continuing appropriate treatment is arranged following CEAH. Crucially, transfer for CEAH or another location is fundamentally a PIC transfer, so it requires the same meticulous planning as other semielective critical care transports.…”

Section: Crucial Considerationsmentioning

confidence: 99%

“…As the process became standardized in some settings, case series emerged (4), and local policies and pathways were published (5,6). The article by Woodruff et al (7) published in this issue of Pediatric Critical Care Medicine helpfully adds to this in bringing together essential principles for all PIC teams to consider in offering CEAH to families facing their child's end-of-life in PIC.…”

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confidence: 99%

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There’s No Place Like Home*

Brierley

2021

Pediatric Critical Care Medicine

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“…Woodruff AG, Bingham SB, Jarrah RJ, et al: A Framework for Pediatric Intensivists Providing Compassionate Extubation at Home (2).…”

Section: What Are the Intricacies Of Decision-making Around End-of-li...mentioning

confidence: 99%

Editor’s Choice Articles for May

Tasker

2021

Pediatric Critical Care Medicine

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Iam very pleased to be presenting a new issue of Pediatric Critical Care Medicine (PCCM). Here are another three Editor's Choice articles, but with a difference. If there is a theme, it is that these articles with their supporting content and editorial materials, together provide a wealth of new clinically relevant information.The first article is about hyperoxia during cardiopulmonary bypass and its association with greater odds of morbidity and mortality (1). The second article reports a framework for compassionate end-of-life endotracheal extubation at home (2). My third choice describes the feasibility of implementing a new tool for serial neurologic assessment in pediatrics (SNAP) in critically ill patients (3). All three articles (1-3) and related editorial material (4-7) will be freely available for the next two months.

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A Framework for Pediatric Intensivists Providing Compassionate Extubation at Home*

Cited by 7 publications

References 25 publications

Palliative and Critical Care: Their Convergence in the Pediatric Intensive Care Unit

Palliative and Critical Care: Their Convergence in the Pediatric Intensive Care Unit

There’s No Place Like Home*

Editor’s Choice Articles for May

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