Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units

Alicja Bartkowska-Śniatkowska; Elżbieta Byrska-Maciejasz; Maciej Cettler; Maria Damps; Konrad Jarosz; Magdalena Mierzewska-Schmidt; Marek Migdał; Irena Ożóg-Zabolska; Andrzej Piotrowski; Marcin Rawicz; Magdalena Świder; Mariola Tałałaj; Marzena Zielińska

doi:10.5114/ait.2021.111451

eISSN: 1731-2531
ISSN: 1642-5758

Anaesthesiology Intensive Therapy

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abstract:

Special paper

Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units

Alicja Bartkowska-Śniatkowska

¹

,

Elżbieta Byrska-Maciejasz

²

,

Maciej Cettler

³

,

Maria Damps

⁴

,

Konrad Jarosz

⁵

,

Magdalena Mierzewska-Schmidt

⁶

,

Marek Migdał

⁷

,

Irena Ożóg-Zabolska

⁸

,

Andrzej Piotrowski

⁹

,

Marcin Rawicz

¹⁰

,

Magdalena Świder

¹¹

,

Mariola Tałałaj

¹²

,

Marzena Zielińska

¹³

Department of Paediatric Anaesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznań, Poland
Department of Anaesthesiology and Intensive Therapy, University Children’s Hospital of Cracow, Poland
Department of Anaesthesiology and Intensive Therapy for Kids, Provincial Polyclinical Hospital in Toruń, Poland
Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland
Department of Clinical Nursing, Pomeranian Medical University, Szczecin, Poland
Department of Paediatric Anaesthesiology and Intensive Therapy, Medical University of Warsaw, Poland
Children’s Memorial Health Institute, Warsaw, Poland
Department of Paediatric Anaesthesiology and Intensive Therapy, COPERNICUS PL, Gdańsk, Poland
Department of Neonatology, Medical University of Warsaw, Poland
The Warsaw Hospital for Sick Children, Warsaw, Poland
Department of Anaesthesiology and Critical Care Medicine, Clinical Provincial Hospital No. 2 in Rzeszów, Poland
Department of Anaesthesiology and Intensive Care of Children and Adolescents with the Postoperative and Pain Management Department, Bialystok Medical University, Białystok, Poland
Department of Paediatric Anaesthesiology and Intensive Care, Wroclaw Medical University, Wrocław, Poland

Anaesthesiol Intensive Ther 2021; 53, 5: 369–375

DOI: https://doi.org/10.5114/ait.2021.111451

Online publish date: 2021/12/30

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AMA

Bartkowska-Śniatkowska A, Byrska-Maciejasz E, Cettler M, et al. Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units. Anaesthesiology Intensive Therapy. 2021;53(5):369-375. doi:10.5114/ait.2021.111451.

APA

Bartkowska-Śniatkowska, A., Byrska-Maciejasz, E., Cettler, M., Damps, M., Jarosz, K.,  & Mierzewska-Schmidt, M. et al. (2021). Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units. Anaesthesiology Intensive Therapy, 53(5), 369-375. https://doi.org/10.5114/ait.2021.111451

Chicago

Bartkowska-Śniatkowska, Alicja, Elżbieta Byrska-Maciejasz, Maciej Cettler, Maria Damps, Konrad Jarosz, Magdalena Mierzewska-Schmidt,  and Marek Migdał et al. 2021. "Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units". Anaesthesiology Intensive Therapy 53 (5): 369-375. doi:10.5114/ait.2021.111451.

Harvard

Bartkowska-Śniatkowska, A., Byrska-Maciejasz, E., Cettler, M., Damps, M., Jarosz, K., Mierzewska-Schmidt, M., Migdał, M., Ożóg-Zabolska, I., Piotrowski, A., Rawicz, M., Świder, M., Tałałaj, M.,  and Zielińska, M. (2021). Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units. Anaesthesiology Intensive Therapy, 53(5), pp.369-375. https://doi.org/10.5114/ait.2021.111451

MLA

Bartkowska-Śniatkowska, Alicja et al. "Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units." Anaesthesiology Intensive Therapy, vol. 53, no. 5, 2021, pp. 369-375. doi:10.5114/ait.2021.111451.

Vancouver

Bartkowska-Śniatkowska A, Byrska-Maciejasz E, Cettler M, Damps M, Jarosz K, Mierzewska-Schmidt M et al. Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units. Anaesthesiology Intensive Therapy. 2021;53(5):369-375. doi:10.5114/ait.2021.111451.

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In Poland, guidelines for the management of ineffective treatment of children in neonatal and paediatric departments developed by the Polish Neonatal Society and the Polish Paediatric Society, have been published. The specific problems of futile therapy in paediatric anaesthesiology and intensive care units should be defined and solved separately. For this purpose, the guidelines presented below were prepared. They present the principles for managing children for whom therapeutic options available in paediatric anaesthesiology and intensive care units have been exhausted and ineffectiveness of maintaining organ functions, i.e. futile therapy, has been suspected. The decision to withdraw futile therapy of a child is undoubtedly one of the most difficult for both doctors and parents, and for this reason, it should be made collectively, respecting the dignity of the child and his/her parents or legal representatives, and continuing the management aimed at relieving the child’s pain and suffering, as well as minimising anxiety and fear. Due to the small amount of reliable evidence-based data, the guidelines constitute the consensus of the Group of Experts and are dedicated to minor patients treated in paediatric anaesthesiology and intensive care units.

keywords:

Guidelines regarding ineffective maintenance of organ functions (futile therapy) in paediatric intensive care units

futile therapy, palliative care, paediatric intensive care unit