End-of-life course and subspecialty palliative care involvement for children on mechanical circulatory support: Five-center retrospective cohort study from the United States, 2015–2020

End-of-life course and subspecialty palliative care involvement for children on mechanical circulatory support: Five-center retrospective cohort study from the United States, 2015–2020
Pediatric Critical Care Medicine; by Zasha Vazquez Colon, Lorelei Robinson, Dalia Lopez-Colon, Anna Joong, Elisha Waldman, Claudia Delgado-Corcoran, Lindsay J. May, Melissa K. Cousino, David M. Peng, Stevan Lukich, Elizabeth D. Blume, Desiree S. Machado, Katie M. Moynihan; 7/25
Objectives: To characterize end-of-life (EOL) care and subspecialty palliative care (SPC) involvement in children with heart disease supported on mechanical circulatory support (MCS), including ventricular assist devices (VADs) and extracorporeal membrane oxygenation (ECMO). Most pediatric deaths after MCS occur soon after discontinuation of devices while receiving invasive therapies in ICUs. SPC teams were involved in less than half of the cases, with only 21% being consulted early. SPC was associated with more ACP [advance care planning] and less CPR at EOL.