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.
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