BACKGROUND: Pediatric patients affected by oncologic disease have a significant risk of clinical deterioration that requires admission to the intensive care unit. This study reported the results of a national survey describing the characteristics of Italian onco-hematological units (OHUs) and pediatric intensive care units (PICUs) that admit pediatric patients, focusing on the high-complexity treatments available before PICU admission, and evaluating the approach to the end-of -life (EOL) when cared in a PICU setting.METHODS: A web-based electronic survey has been performed in April 2021, involving all Italian PICUs admitting pediatric patients with cancer participating in the study.RESULTS: Eighteen PICUs participated, with a median number of admissions per year of 350 (IQR 248-495). Availability of Extracorporeal Membrane Oxygenation therapy and the presence of intermediate care unit are the only statistically different characteristics between large or small PICUs. Different high-level treatments and protocols are performed in OHUs, non depending on the volume of PICU. Palliative sedation is mainly performed in the OHUs (78%), however, in 72% it is also performed in the PICU. In most centers protocols that address EOL comfort care and treatment algorithms are missing, non depending on PICU or OHU volume.CONCLUSIONS: A non-homogeneous availability of high-level treatments and in OHUs is described. Moreover, proto-cols addressing EOL comfort care and treatment algorithms in palliative care are lacking in many centers.(Cite this article as: Martinato M, Comoretto RI, Biban P, Zanonato E, Simonini A, Montaguti A, et al.; OncoTIPnet Study Group. Italian pediatric intensive care units admitting critically ill cancer children: results from a national survey. Minerva Anestesiol 2023;89:850-8. DOI: 10.23736/S0375-9393.23.17329-9)
Italian pediatric intensive care units admitting critically ill cancer children: results from a national survey
Gitto, Eloisa;
2023-01-01
Abstract
BACKGROUND: Pediatric patients affected by oncologic disease have a significant risk of clinical deterioration that requires admission to the intensive care unit. This study reported the results of a national survey describing the characteristics of Italian onco-hematological units (OHUs) and pediatric intensive care units (PICUs) that admit pediatric patients, focusing on the high-complexity treatments available before PICU admission, and evaluating the approach to the end-of -life (EOL) when cared in a PICU setting.METHODS: A web-based electronic survey has been performed in April 2021, involving all Italian PICUs admitting pediatric patients with cancer participating in the study.RESULTS: Eighteen PICUs participated, with a median number of admissions per year of 350 (IQR 248-495). Availability of Extracorporeal Membrane Oxygenation therapy and the presence of intermediate care unit are the only statistically different characteristics between large or small PICUs. Different high-level treatments and protocols are performed in OHUs, non depending on the volume of PICU. Palliative sedation is mainly performed in the OHUs (78%), however, in 72% it is also performed in the PICU. In most centers protocols that address EOL comfort care and treatment algorithms are missing, non depending on PICU or OHU volume.CONCLUSIONS: A non-homogeneous availability of high-level treatments and in OHUs is described. Moreover, proto-cols addressing EOL comfort care and treatment algorithms in palliative care are lacking in many centers.(Cite this article as: Martinato M, Comoretto RI, Biban P, Zanonato E, Simonini A, Montaguti A, et al.; OncoTIPnet Study Group. Italian pediatric intensive care units admitting critically ill cancer children: results from a national survey. Minerva Anestesiol 2023;89:850-8. DOI: 10.23736/S0375-9393.23.17329-9)Pubblicazioni consigliate
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