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Background and objectives <p>This study aimed to evaluate the implementation and impact of futile therapy (FT) protocols in pediatric intensive care units (PICUs) in Poland.</p> Methods <p>A retrospective analysis 48 futile therapy protocols signed at three academic pediatric intensive care units (PICUs) in southern Poland. A designated individual at each of the hospitals gathered detailed data from the protocols.</p> Results <p>The children’s ages ranged from 1 month to 18 years, the primary diagnoses were neurological conditions (<i>n</i> = 22, 45.83%), oncological conditions (<i>n</i> = 11, 22.92%), and prematurity (<i>n</i> = 9, 19.75%). The most common concomitant complications included severe birth asphyxia (<i>n</i> = 21, 43.75%), chronic respiratory failure (<i>n</i> = 18, 37.50%), circulatory failure (<i>n</i> = 10, 20.85%), and acute respiratory failure (<i>n</i> = 10, 20.85%). More than one-third of the patients were discharged (<i>n</i> = 17, 35.42%), while the remaining patients continued treatment in their primary wards (<i>n</i> = 31, 64.58%). Information on the 37 patients treated at these two centers shows that most (<i>n</i> = 25, 67.57%) died in the ward where they were hospitalized. The survival time after the protocol was signed ranged from 2 to 705 days, with a median of 42 days.</p> Conclusions <p>The guidelines implemented in the study centers facilitated decision-making regarding the discontinuation of FT. The protocol was most frequently applied to newborns and children under 1 year of age. A median of survival time after implement FTP affirming the positive role of palliative care.</p>

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Futile therapy protocols: A 3-year review of the implementation of Polish guidelines on ineffective organ function maintenance in pediatric intensive care unit—A pilot study

  • 期刊论文

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  • 发表日期：

    2025年4月25日

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  • Maria Damps,
  • Beata Rybojad,
  • Alicja Bartkowska-Śniatkowska,
  • Anna Aftyka

摘要

Background and objectives

This study aimed to evaluate the implementation and impact of futile therapy (FT) protocols in pediatric intensive care units (PICUs) in Poland.

Methods

A retrospective analysis 48 futile therapy protocols signed at three academic pediatric intensive care units (PICUs) in southern Poland. A designated individual at each of the hospitals gathered detailed data from the protocols.

Results

The children’s ages ranged from 1 month to 18 years, the primary diagnoses were neurological conditions (n = 22, 45.83%), oncological conditions (n = 11, 22.92%), and prematurity (n = 9, 19.75%). The most common concomitant complications included severe birth asphyxia (n = 21, 43.75%), chronic respiratory failure (n = 18, 37.50%), circulatory failure (n = 10, 20.85%), and acute respiratory failure (n = 10, 20.85%). More than one-third of the patients were discharged (n = 17, 35.42%), while the remaining patients continued treatment in their primary wards (n = 31, 64.58%). Information on the 37 patients treated at these two centers shows that most (n = 25, 67.57%) died in the ward where they were hospitalized. The survival time after the protocol was signed ranged from 2 to 705 days, with a median of 42 days.

Conclusions

The guidelines implemented in the study centers facilitated decision-making regarding the discontinuation of FT. The protocol was most frequently applied to newborns and children under 1 year of age. A median of survival time after implement FTP affirming the positive role of palliative care.