Decision-Making, Ethics, and End-of-Life Care in Pediatric Extracorporeal Membrane Oxygenation: A Comprehensive Narrative Review.

Autor:	Moynihan KM; Department of Cardiology, Division of Cardiovascular Critical Care, Boston Children's Hospital Boston, MA.; Department of Pediatrics, Harvard Medical School, Boston, MA.; School of Medicine, University of Queensland, Brisbane, VIC, Australia.; Boston Children's Hospital Medical Library, Boston, MA.; Divisions of Pediatric Cardiology and Critical Care Medicine, Department of Pediatrics, Washington University in St Louis, St Louis, MO.; Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA.; Division of Critical Care, Children's National Hospital, Washington, DC., Dorste A; Boston Children's Hospital Medical Library, Boston, MA., Siegel BD; Department of Cardiology, Division of Cardiovascular Critical Care, Boston Children's Hospital Boston, MA.; Department of Pediatrics, Harvard Medical School, Boston, MA., Rabinowitz EJ; Divisions of Pediatric Cardiology and Critical Care Medicine, Department of Pediatrics, Washington University in St Louis, St Louis, MO., McReynolds A; Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA., October TW; Division of Critical Care, Children's National Hospital, Washington, DC.
Jazyk:	angličtina
Zdroj:	Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Pediatr Crit Care Med] 2021 Sep 01; Vol. 22 (9), pp. 806-812.
DOI:	10.1097/PCC.0000000000002766
Abstrakt:	Objectives: Pediatric extracorporeal membrane oxygenation is associated with significant morbidity and mortality. We sought to summarize literature on communication and decision-making, end-of-life care, and ethical issues to identify recommended approaches and highlight knowledge gaps. Data Sources: PubMed, Embase, Web of Science, and Cochrane Library. Study Selection: We reviewed published articles (1972-2020) which examined three pediatric extracorporeal membrane oxygenation domains: 1) decision-making or communication between clinicians and patients/families, 2) ethical issues, or 3) end-of-life care. Data Extraction: Two reviewers independently assessed eligibility using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Data Synthesis: Of 2,581 publications screened, we identified one systematic review and 35 descriptive studies. No practical guides exist for communication and decision-making in pediatric extracorporeal membrane oxygenation. Conversation principles and parent/clinician perspectives are described. Ethical issues related to consent, initiation, discontinuation, resource allocation, and research. No patient-level synthesis of ethical issues or end-of-life care in pediatric extracorporeal membrane oxygenation was identified. Conclusions: Despite numerous ethical issues reported surrounding pediatric extracorporeal membrane oxygenation, we found limited patient-level research and no practical guides for communicating with families or managing extracorporeal membrane oxygenation discontinuation. Competing Interests: The authors have disclosed that they do not have any potential conflicts of interest. (Copyright © 2021 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.)
Databáze:	MEDLINE
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