Attitudes differ among pediatric ICU providers
Attitudes among nurses and physicians regarding life-support interventions for critically ill children can vary markedly even within a single ICU, according to a study supported by the Rockville, MD-based Agency for Health Care Policy and Research.1
Physicians and nurses with about 10 years of experience in pediatric ICUs were asked about their willingness to use life-support interventions in various scenarios.
Clinicians, for example, were asked if they would use vasopressors, such as adrenaline, to boost flagging blood pressure, perform chest compressions, or withdraw life support for hypothetical 7- or 8-year-old patients with congenital heart disease. The scenarios varied concerning dependency and neurologic status of the child, stability and wishes of the family, and predicated chance of survival. Based on answers to a questionnaire, half of the 56 caregivers at one ICU would use life-support measures and half would not for the same patient. The most important factors influencing decisions were family preferences (76%), probability of survival (50%), and the patient’s functional status (47%).
Reference
1. Randolph A, Zollo M, Wigton R, et al. Factors explaining variability among caregivers in the intent to restrict life-support interventions in a pediatric intensive care unit. Critical Care Medicine 1997; 25:435-439.
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