End of life in pediatric intensive care units

Abstract

This article analyzes end-of-life procedures in Brazilian pediatric intensive care units. This is an observational, retrospective, multicenter study, including children who died between January and December 2017. During the period, 149 deaths occurred, of which 54 were selected. We found that 83.3% of patients had a base illness, being septic shock the main cause of death (38.9%). Life support limitations were described in 46.3% of the medical records, and a do-not-resuscitate order for 37% of the patients; however, 74.1% were not resuscitated. The practice of not resuscitating patients with a reserved prognosis and better care in the last 48 hours of life have become more common in recent years. However, there are still excessive use of invasive procedures, mechanical ventilation, and vasoactive drugs in the last hours of life.

Hospice care; Death; Intensive care units, pediatric; Palliative care; Child care; Critical care