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- W4238518753 abstract "Objectives: To document the beliefs and practices of UK paediatric intensive care unit (PICU) consultant medical staff in withdrawing ventilatory support from children who are terminally ill, but not brain dead. While all dying children should be treated individually, there is little in the literature to guide doctors in the manner in which ventilation should be discontinued. Better understanding of current practice may help formulate a rational and compassionate approach to withdrawal of ventilation. Design: Questionnaires were posted to 93 consultants involved in the management of children in 19 paediatric and 14 mixed adult/paediatric ICUs in the UK. Questions related specifically to the withdrawal of ventilation from dying children beyond the neonatal age group (one month to 16 years). There were 73 respondents (78%). Results: Thirty-one (42%) respondents preferred extubation to terminal weaning, including nine (12%) who continued paralysis during extubation. Twenty-four (33%) respondents preferred terminal weaning, 14 of whom decreased the FiO2 as the first step. Consultants who graduated after 1980 were no more likely to practise extubation than their older colleagues. Thirty-six (49%) used a higher than standard dose of sedative during the process of withdrawal. Conclusion: Once a consensus has been reached that death is inevitable, and that further prolongation of life is not only futile but intolerable, then the principal concern of the doctor should be the comfort of the child and family. Withdrawal of ventilation should be carried out with dignity and humanity, and concluded as rapidly as possible. Extubation was the preferred method of withdrawal in our survey, with a significant minority of respondents continuing neuromuscular paralysis." @default.
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- W4238518753 date "1997-10-01" @default.
- W4238518753 modified "2023-10-18" @default.
- W4238518753 title "Withdrawal of ventilation from the dying child" @default.
- W4238518753 doi "https://doi.org/10.1080/714029025" @default.
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