End-of-life discussions and advance care planning for children on long-term assisted ventilation with life-limiting conditions.

摘要: Families of children with life-limiting conditions who are on long-term assisted ventilation need to undertake end-of-life advance care planning (ACP) in order align their goals and values the inevitability child's condition risks it entails. To discuss how best conduct ACP this population, we performed a retrospective analysis discussions involving our deceased ventilator-assisted patients between 1987 2009. A total 34 (72 percent) 47 study were subject these discussions; many occurred after acute deterioration. They resulted directives forgo or limit interventions for 21 (45 percent). We surmise that families hesitant issues during periods relative stability. By offering anticipatory guidance encouraging contemplation patients' both times stability worsening illness, health providers can better engage ACP. As progresses, emphasis be recalibrated. How respond such encouragement also serve as gauge willingness pursue