Modes of Death in a Pediatric Cardiac ICU

Angelo Polito, Cristiana Garisto, Chiara Pezzella, Claudia Iacoella, Paola E. Cogo

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Abstract

OBJECTIVE:: To determine epidemiology and proximate causes of death in a pediatric cardiac ICU in Southern Europe. DESIGN:: Retrospective chart review. SETTING:: Single-center institution. PATIENTS:: We concurrently identified 57 consecutive patients who died prior to discharge from the cardiac ICU. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Over the study period, there were 57 deaths for a combined mortality rate of 2.4%. Four patients (7%) were declared brain dead, 25 patients (43.8%) died after a failed resuscitation attempt, and 28 patients (49.1%) died after withholding or withdrawal of life-sustaining treatment. Cardiorespiratory failure was the most frequent proximate cause of death (39, 68.4%) followed by brain injury (14, 24.6%) and septic shock (4, 7%). Older age at admission, presence of mechanical ventilation and/or device-dependent nutrition support, patients on a left-ventricular assist device and longer cardiac ICU stay were more likely to have life support withheld or withdrawn. CONCLUSIONS:: Almost half of the deaths in the cardiac ICU are predictable, and they are anticipated by the decision to limit life-sustaining treatments. Brain injuries play a direct role in the death of 25% of patients who die in the cardiac ICU. Patients with left-ventricular assist device are associated with withdrawal of treatment.

Original languageEnglish
JournalPediatric Critical Care Medicine
DOIs
Publication statusAccepted/In press - Feb 26 2016

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ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

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