Short Sara Rhodes, Thienprayoon Rachel
Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Transl Pediatr. 2018 Oct;7(4):326-343. doi: 10.21037/tp.2018.09.11.
This article reviews the state and practice of pediatric palliative care (PC) within the pediatric intensive care unit (PICU) with specific consideration of quality issues. This includes defining PC and end of life (EOL) care. We will also describe PC as it pertains to alleviating children's suffering through the provision of "concurrent care" in the ICU environment. Modes of care, and attendant strengths, of both the consultant and integrated models will be presented. We will review salient issues related to the provision of PC in the PICU, barriers to optimal practice, parental, and staff perceptions. Opportunity areas for quality improvement and the role of initiatives and measures such as education, family-based initiatives, staff needs, symptom recognition, grief, and communication follow. To conclude, we will look to the literature for PC resources for pediatric intensivists and future directions of study.
本文回顾了儿科重症监护病房（PICU）内儿科姑息治疗（PC）的现状与实践，并特别考虑了质量问题。这包括对PC和临终（EOL）护理的定义。我们还将描述在ICU环境中通过提供“同步护理”来缓解儿童痛苦的PC。将介绍顾问模式和综合模式的护理方式及其相应优势。我们将回顾与PICU中提供PC相关的突出问题、最佳实践的障碍、家长和工作人员的看法。接下来是质量改进的机会领域以及教育、家庭倡议、工作人员需求、症状识别、悲伤和沟通等举措和措施的作用。最后，我们将查阅文献，寻找儿科重症监护医生的PC资源以及未来的研究方向。
