Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping Review

Aim. This scoping review is aimed at systematically mapping the evidence on palliative extubation in the pediatric intensive care unit. Methods. MEDLINE, EBSCO, and Cochrane databases were searched for articles published between January 2018 and December 2022, in English. Critical appraisal of sourc...

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Main Authors: Joana Neto, Hugo Jorge Casimiro, Paulo Reis-Pina
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:International Journal of Pediatrics
Online Access:http://dx.doi.org/10.1155/2023/6697347
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author Joana Neto
Hugo Jorge Casimiro
Paulo Reis-Pina
author_facet Joana Neto
Hugo Jorge Casimiro
Paulo Reis-Pina
author_sort Joana Neto
collection DOAJ
description Aim. This scoping review is aimed at systematically mapping the evidence on palliative extubation in the pediatric intensive care unit. Methods. MEDLINE, EBSCO, and Cochrane databases were searched for articles published between January 2018 and December 2022, in English. Critical appraisal of sources of evidence was done using the Joanna Briggs Institute tools. PRISMA guidelines for scoping reviews were followed. Results. Six studies were included, with 366 patients, from the USA (n=4), Brazil (n=1), and Germany (n=1). Three were high-quality studies, two were moderate, and one was a low-quality study. Most studies were retrospective analysis; two were narrative approaches; two were evidence-based recommendation and quality improvement project; one study was a prospective intervention. Conclusion. Symptom control is crucial pre- and postextubation. A checklist (symptom management and family support) and a postdebriefing template improve team communication and staff support postextubation. Critical care transports from the hospital are feasible to provide extubation at home. A framework addressing common planning challenges and resource management is recommended for extubation at home. The provision of pediatric palliative extubation is necessary since futile measures and prolongation of suffering violate the principle of nonmaleficence. Future research on this subject will result in more benefits for patients, parents, and professionals.
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spelling doaj-art-dbf3bc471c5f471a96fc8312e892ecf62025-08-20T03:23:57ZengWileyInternational Journal of Pediatrics1687-97592023-01-01202310.1155/2023/6697347Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping ReviewJoana Neto0Hugo Jorge Casimiro1Paulo Reis-Pina2Faculty of MedicineFaculty of MedicineFaculty of MedicineAim. This scoping review is aimed at systematically mapping the evidence on palliative extubation in the pediatric intensive care unit. Methods. MEDLINE, EBSCO, and Cochrane databases were searched for articles published between January 2018 and December 2022, in English. Critical appraisal of sources of evidence was done using the Joanna Briggs Institute tools. PRISMA guidelines for scoping reviews were followed. Results. Six studies were included, with 366 patients, from the USA (n=4), Brazil (n=1), and Germany (n=1). Three were high-quality studies, two were moderate, and one was a low-quality study. Most studies were retrospective analysis; two were narrative approaches; two were evidence-based recommendation and quality improvement project; one study was a prospective intervention. Conclusion. Symptom control is crucial pre- and postextubation. A checklist (symptom management and family support) and a postdebriefing template improve team communication and staff support postextubation. Critical care transports from the hospital are feasible to provide extubation at home. A framework addressing common planning challenges and resource management is recommended for extubation at home. The provision of pediatric palliative extubation is necessary since futile measures and prolongation of suffering violate the principle of nonmaleficence. Future research on this subject will result in more benefits for patients, parents, and professionals.http://dx.doi.org/10.1155/2023/6697347
spellingShingle Joana Neto
Hugo Jorge Casimiro
Paulo Reis-Pina
Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping Review
International Journal of Pediatrics
title Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping Review
title_full Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping Review
title_fullStr Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping Review
title_full_unstemmed Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping Review
title_short Palliative Extubation in Pediatric Patients in the Intensive Care Unit and at Home: A Scoping Review
title_sort palliative extubation in pediatric patients in the intensive care unit and at home a scoping review
url http://dx.doi.org/10.1155/2023/6697347
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