부산대학교 도서관

Background. Availability of paediatric intensive care (PICU) beds is a scarce resource in South Africa. Difficult decisions, such as limitation and withdrawal of life-sustaining therapy, are inevitable to optimise the use of PICU beds. Objectives. To describe the characteristics and modes of death in a South African PICU. Methods. Retrospective review of data extracted from the Child Healthcare Problem Identification Programme (Child PIP) and the PICU summary system on children of any age who died in the PICU between 1 January 2013 and 31 December 2017. Results. There were 451 deaths reviewed (54% male), with a median (interquartile range (IQR)) age of 7 (1 - 30) months. The median (IQR) length of PICU stay prior to death was 3 (1 - 7) days. The mode of death in 23.7% (n=107) was withdrawal of life-sustaining therapies; 36.14% (n=163) died after limitation of life-sustaining therapies; 22.0% (n=99) died after failed resuscitation; and 17.3% (n=78) were diagnosed brain dead. Ultimately, 60% (n=270) of children died after the decision was made to limit or withdraw life-sustaining therapies. Septicaemia (20.4%) was the most common cause of death. Only 1.5% (n=7) of deaths became organ donors. Conclusions. Most children died after a decision to limit or withdraw life-sustaining therapy.
M Wege, (1,2) B Morrow, (1) B Rossouw, (1,2) A C Argent (1,2) (1) Department of Paediatrics and Child Health, University of Cape Town, South Africa (2) Red Cross War [...]