Palliative Care in Children With Heart Disease Treated in an ICU
Objectives: Describe pediatric palliative care consult in children with heart disease; retrospectively apply Center to Advance Palliative Care criteria for pediatric palliative care consults; determine the impact of pediatric palliative care on end of life. Design: A retrospective single-center study. Setting: A 16-bed cardiac ICU in a university-affiliated tertiary care children’s hospital. Patients: Children (0–21 yr old) with heart disease admitted to the cardiac ICU from January 2014 to June 2017. Measurements and Main Results: Over 1,000 patients (n = 1, 389) were admitted to the cardiac ICU with 112 (8%) receiving a pediatric palliative care consultation. Patients who received a consult were different from those who did not. Patients who received pediatric palliative care were younger at first hospital admission (median 63 vs 239 d; p = 0.003), had a higher median number of complex chronic conditions at the end of first hospitalization (3 vs 1; p
Conclusion: Congenital heart disease in the State of Jalisco is an important cause of mortality, with a high incidence and a very limited resolution capacity since the health services in the State of Jalisco for the care of these patients are insufficient and inadequate. It is essential to strengthen the health system for the care for these patients. PMID: 32459213 [PubMed - as supplied by publisher]
My city, Louisville KY, recently had a spike in COVID19 infections. It came from a handful of nursing homes. That nursing home and long-term care facilities account for large percentages of COVID19 cases has been well documented. In some cities, the majority of cases come from these facilities. These facts have sprouted platitudes about “protecting our elderly.” What makes this a platitude is that it belies the challenges faced by nursing facilities. Two recent papers shed light on these challenges. First is an article by Chris Pope in the City Journal. Second is an academic-like defense of Stoc...
Journal of Palliative Medicine, Ahead of Print.
CONCLUSION: Children dying of advanced heart disease receive intensive treatment at the end of life. Discussions regarding end-of-life issues are often postponed until immediately prior to death. A pediatric palliative care program must be implemented to improve the quality of death in pediatric patients with heart disease. PMID: 32329256 [PubMed - in process]
ski T Abstract Many cardiovascular diseases lead to heart failure, which is a progressive syndrome causing significant distress and limiting the quality of life, despite optimal cardiologic treatment. It is estimated that about 26 000 people in Poland suffer from advanced heart failure, and this number is growing. That is why palliative care (PC) dedicated to people living with end‑stage cardiac diseases should be urgently implemented in Poland. Well‑organized PC may not only relieve symptoms and improve quality of life in people living with cardiac diseases not responding to treatment but also support patient...
Conclusion: Implementing a strategy to reduce postoperative chylothorax resulted in an acceptable incidence of postoperative chylothorax. Instituting a clinical practice protocol helped to curtail the treatment duration and to decrease the requirement for surgical treatment. Image-guided embolization of the thoracic duct is an effective treatment for postoperative chylothorax. PMID: 32309201 [PubMed]
The American Heart Association and American Stroke Association have put forth statement recommending early and continuous access to palliative care for patients with heart disease. There is a national shortage of palliative care providers, and often outpatient palliative care clinics are not profitable to institutions with billing alone. However, early integration of palliative care has been proven to improve the quality of life of patients with advanced heart failure. Other studies have suggested that general palliative care has cost savings to hospital systems.
CONCLUSIONS: More neonatal surgeries (491 vs. 74 patients) were performed than those in the past (1984-1999). The surgical outcomes were much better than before. Our surgical outcomes revealed that the Republic of Korea has been transformed from a country receiving help to a country that helps other low socioeconomic status countries. PMID: 32212426 [PubMed - as supplied by publisher]
CONCLUSION: This study bridges an important knowledge gap regarding symptoms, concerns and outcomes that matter to children living with life-limiting conditions and their families and informs service development and evaluation. PMID: 32081084 [PubMed - as supplied by publisher]
Conclusion: PO as a method of screening helps in early diagnosis of CHD added to clinical and echocardiography studies. KMM fosters innovation and resource management. PMID: 31996861 [PubMed - in process]