ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2015
End-of-Life Practices Among Tertiary Care PICUs in the United States: A Multicenter Study.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
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Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Ethics and end-of-life in pediatric and neonatal ICUs: a systematic review of recommendations.BMC palliative care · 2025Pooled it
- The elements of end-of-life care provision in paediatric intensive care units: a systematic integrative review.BMC palliative care · 2024Pooled it
- Telling is Caring: Prioritizing the Best Interests of Dying Children.HEC forum : an interdisciplinary journal on hospitals' ethical and legal issues · 2026Article
- Impact of a shared pediatric palliative care program on end-of-life care trends among children: a 10-year retrospective study in Taiwan.BMC palliative care · 2026Article
- Race, Ethnicity, and Social Determinants of Health in PICU Mode of Death: Single-Center Retrospective Cohort Study.Critical care explorations · 2026Article
- Ventilator Weaning and Terminal Extubation: Withdrawal of Life-Sustaining Therapy in Children. Secondary Analysis of the Death One Hour After Terminal Extubation Study.Critical care medicine · 2024Article
- Navigating the shadows: medical professionals' values and perspectives on end-of-life care within pediatric intensive care units in Croatia.Frontiers in pediatrics · 2024Article
- Paediatric death after withdrawal of life-sustaining therapies: a scoping review protocol.BMJ open · 2022Article
- Predicting Time to Death After Withdrawal of Life-Sustaining Treatment in Children.Critical care explorations · 2022Review
- Shifting and intersecting needs: Parents' experiences during and following the withdrawal of life sustaining treatments in the paediatric intensive care unit.Intensive & critical care nursing · 2022Article
- Nursing Care at End of Life in Pediatric Intensive Care Unit Patients Requiring Mechanical Ventilation.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2022Article
- End-of-Life Decision-Making in Pediatric and Neonatal Intensive Care Units in Croatia-A Focus Group Study among Nurses and Physicians.Medicina (Kaunas, Lithuania) · 2022Article
- Is this as good as it gets? Implications of an asymptotic mortality decline and approaching the nadir in pediatric intensive care.European journal of pediatrics · 2022Review
- The criticality Index-mortality: A dynamic machine learning prediction algorithm for mortality prediction in children cared for in an ICU.Frontiers in pediatrics · 2022Article
- Palliative and Critical Care: Their Convergence in the Pediatric Intensive Care Unit.Frontiers in pediatrics · 2022Review
- Causes, timing, and modes of death in a tertiary pediatric intensive care unit: Five years' experience.Saudi medical journal · 2021Article
- Clinical Factors Influencing End-of-Life Care in a Chinese Pediatric Intensive Care Unit: A Retrospective,Frontiers in pediatrics · 2021Article
- Severity Trajectories of Pediatric Inpatients Using the Criticality Index.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2021Article
- Defining a "Good Death" in the Pediatric Intensive Care Unit.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2020Review
- Performance of Three Mortality Prediction Scores and Evaluation of Important Determinants in Eight Pediatric Intensive Care Units in China.Frontiers in pediatrics · 2020Article
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
objectiveTo describe variability in end-of-life practices among tertiary care PICUs in the United States.
designSecondary analysis of data prospectively collected from a random sample of patients (n = 10,078) admitted to PICUs affiliated with the Collaborative Pediatric Critical Care Research Network between December 4, 2011, and April 7, 2013.
settingSeven clinical centers affiliated with the Collaborative Pediatric Critical Care Research Network. PATIENTS: Patients included in the primary study were less than 18 years old, admitted to a PICU, and not moribund on PICU admission. Patients included in the secondary analysis were those who died during their hospital stay.
interventionsNone. MEASUREMENTS AND MAIN
resultsTwo hundred and seventy-five (2.7%; range across sites, 1.3-5.0%) patients died during their hospital stay; of these, 252 (92%; 76-100%) died in a PICU. Discussions with families about limitation or withdrawal of support occurred during the initial PICU stay for 173 patients (63%; 47-76%; p = 0.27) who died. Of these, palliative care was consulted for 67 (39%; 12-46%); pain service for 11 (6%; 10 of which were at a single site); and ethics committee for six (3%, from three sites). Mode of death was withdrawal of support for 141 (51%; 42-59%), failed cardiopulmonary resuscitation for 53 (19%; 12-28%), limitation of support for 46 (17%; 7-24%), and brain death for 35 (13%; 8-20%); mode of death did not differ across sites (p = 0.58). Organ donation was requested from 101 families (37%; 17-88%; p < 0.001). Of these, 20 donated (20%; 0-64%). Sixty-two deaths (23%; 10-53%; p < 0.001) were medical examiner cases. Of nonmedical examiner cases (n = 213), autopsy was requested for 79 (37%; 17-75%; p < 0.001). Of autopsies requested, 53 (67%; 50-100%) were performed.
conclusionsMost deaths in Collaborative Pediatric Critical Care Research Network-affiliated PICUs occur after life support has been limited or withdrawn. Wide practice variation exists in requests for organ donation and autopsy.
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