Pediatr Crit Care Me
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To describe the health outcomes of bereaved parents and identify practical strategies for critical care providers as they support and provide anticipatory guidance to bereaved parents. ⋯ The death of a child is a traumatic experience that can put parents at risk for adverse mental and physical health during bereavement. Health professionals working in PICUs can benefit from knowing these risks to best support bereaved parents, both during their child's hospitalization and in the early postdeath period. The bereavement experience of parents is an adaptive process, and ongoing professional support may be required for vulnerable families. After the child's hospitalization and death, a bereavement follow-up meeting with PICU physician(s) and staff may allow parents to gain additional information, emotional support, and provide an opportunity for parents to give feedback on their experiences.
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Pediatr Crit Care Me · Aug 2018
Neurologic Outcomes After Extracorporeal Membrane Oxygenation: A Systematic Review.
The goal of this systematic review of the literature was to summarize neurologic outcomes following neonatal and pediatric extracorporeal membrane oxygenation. ⋯ This systematic review of the literature suggests that children who have undergone extracorporeal membrane oxygenation suffer from a wide range of disabilities. A meta-analysis was not feasible due to heterogeneity in pathologies, outcome measures, and age at follow-up, underscoring the importance of developing and employing a core set of outcomes measures in future extracorporeal membrane oxygenation studies.
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Pediatr Crit Care Me · Aug 2018
Modes of Death and the Dying Process in Brazilian PICU Over the Last 30 Years: Personal Reflections.
This text is part of the chapter 7 of a special issue supplement called "Death and Dying in PICU" having Christopher S. Parshuram and Karen Dryden-Palmer as the guest editors. ⋯ The PICU mortality rate decreased significantly from over 20% to below 5% as well as the modes of death being observed that the life support limitation is far the most frequent death process in the PICU. Palliative care, in the last 10 years, increased its coverage in our country and being frequently offered as a complementary care to terminal ill patients in the PICU.
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Pediatr Crit Care Me · Aug 2018
Death and Dying in the ICU: Personal Reflection of 30 Years' Experience.
To describe individual perspective over ~30 years in a mixed Cardiac and General ICU, which includes the State Trauma Center, National Cardiac Transplant and Complex Cardiac Center, Extracorporeal Membrane Oxygenation Center, Home Ventilation Program, and the major PICU for 6 million people. ⋯ I have agreed to palliative care in many patients of diverse religious, social, and cultural beliefs while providing long-term ICU care to other patients with similar illnesses and prognosis. This can occur when family meetings allow honest and direct conversation with respect for differences; as a clinician, I listen to a family and understand their perspectives and together develop a clear and agreed plan.
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To describe individual perspective over ~30 years in a PICU in Cape Town, South Africa. ⋯ Narrative, experiential reflection.