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Anaesthesiology Intensive Therapy
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5/2021
vol. 53
 
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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

1.
Department of Paediatric Anaesthesiology and Intensive Therapy, Poznan University of Medical Sciences, Poznań, Poland
2.
Department of Anaesthesiology and Intensive Therapy, University Children’s Hospital of Cracow, Poland
3.
Department of Anaesthesiology and Intensive Therapy for Kids, Provincial Polyclinical Hospital in Toruń, Poland
4.
Department of Anaesthesiology and Intensive Care, Upper Silesian Child Health Centre, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Poland
5.
Department of Clinical Nursing, Pomeranian Medical University, Szczecin, Poland
6.
Department of Paediatric Anaesthesiology and Intensive Therapy, Medical University of Warsaw, Poland
7.
Children’s Memorial Health Institute, Warsaw, Poland
8.
Department of Paediatric Anaesthesiology and Intensive Therapy, COPERNICUS PL, Gdańsk, Poland
9.
Department of Neonatology, Medical University of Warsaw, Poland
10.
The Warsaw Hospital for Sick Children, Warsaw, Poland
11.
Department of Anaesthesiology and Critical Care Medicine, Clinical Provincial Hospital No. 2 in Rzeszów, Poland
12.
Department of Anaesthesiology and Intensive Care of Children and Adolescents with the Postoperative and Pain Management Department, Bialystok Medical University, Białystok, Poland
13.
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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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:

futile therapy, palliative care, paediatric intensive care unit
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