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. 2022 Jun;25(6):952-957.
doi: 10.1089/jpm.2021.0452. Epub 2022 Mar 18.

An Automatic Pediatric Palliative Care Consultation for Children Supported on Extracorporeal Membrane Oxygenation: A Survey of Perceived Benefits and Barriers

Claudia Delgado-Corcoran  1   2 , Sarah E Wawrzynski  3   4 , Kelly J Mansfield  4 , Brian Flaherty  1 , Danielle D DeCourcey  5 , Dominic Moore  2 , Lawrence J Cook  1 , Christina K Ullrich  6   7   8 , Lenora M Olson  1
Affiliations

An Automatic Pediatric Palliative Care Consultation for Children Supported on Extracorporeal Membrane Oxygenation: A Survey of Perceived Benefits and Barriers

Claudia Delgado-Corcoran et al. J Palliat Med. 2022 Jun.

Abstract

Background: Pediatric palliative care (PPC) consultation is infrequent among children on extracorporeal membrane oxygenation (ECMO). Objective: Investigate intensive care unit (ICU) team members' perceptions of automatic PPC consultation for children on ECMO in an ICU in the United States. Methods: Cross-sectional survey assessing benefits, barriers to PPC, and consultation processes. Results: Of 291 eligible respondents, 48% (n = 140) completed the survey and 16% (n = 47) answered an open-ended question. Benefits included support in decision-making (n = 98; 70%) and identification of goals of care (n = 89; 64%). Barriers included perception of giving up on families (n = 59; 42%) and poor acceptability by other team members (n = 58; 41%). Respondents endorsed communication with the primary ICU team before (n = 122; 87%) and after (n = 129; 92%) consultation. Open-ended responses showed more positive (79% vs. 13%) than negative statements. Positive statements reflected on expanding PPC to other critically-ill children where negative statements revealed unrecognized value in PPC. Conclusions: Results demonstrate opportunities for education about the scope of PPC and improvements in PPC delivery.

Keywords: automatic consultation model; extracorporeal membrane oxygenation; intensive care unit; palliative care; pediatrics; survey.

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Conflict of interest statement

No competing financial interests exist.

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