P0448 / #875: END OF LIFE CARE IN BRAZILIAN PICUS: THE MULTIDISCIPLINARY TEAM’S PERSPECTIVES AND PRACTICES

Le résumé fourni par la source

Aims & Objectives: Many PICU practices involving end of life (EoL) care may be dependent on socio-cultural contexts. We aimed to examine EoL care in Brazil, as perceived by the PICU professionals. Methods: A survey tested beforehand, containing Likert style answers and few open questions, was sent via email to professionals in 3 PICUs in Brazil’s center-south hospitals (A.Private, B.Public and a C.University Oncology) as a pilot study. Institutional ethics committees, Gov. research registry and individual consent were obtained. During the 3 months (09-11/2019), 3 reminders were sent. Results: Overall 136 surveys were returned (response rate: 23% total; Physicians: A.31%, B.25%, and C.60%), Overall 35% Physicians, 31% Nurses, 20% Nurses technicians and 14% Physiotherapists responded. Just 34% have frequently/always witnessed EOL with preparation and documentation done; 58% feel unprepared in discussing EOL, 40% never had any training on this area. Despite family agreement, 27% would agree or unsure about withdrawal of treatment. For 51% of physicians, ventilation removal is unacceptable; 88% of Physicians would hold or adjust ventilatory parameters on a terminal patient, only 12% would wean it, none would extubate; in fact, 26% of physicians and 42% of other professionals would wait for cardiac arrest rather than withdraw; 15% have witnessed palliative extubation Conclusions: Most Brazilian PICU professionals surveyed in this partial sample feel ill-prepared to discuss EOL. Even in children with a terminal condition, withholding therapy is preferred; palliative extubation is rare. There is significant discordance between EOL practices in developed countries and Brazil.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.