Surgical and anesthetic decisions for children with terminal illness.
Terminal conditions such as congenital anomalies and cancer are a significant source of infant and childhood mortality. Many terminally ill children are considered for operative procedures each year. These procedures may be palliative or elective, and the prognosis and natural course of the terminal illness play a significant role in determining the appropriateness of the surgical procedure. Providing anesthesia to a terminally ill patient is a complex task requiring an appropriate balance between adequate anesthesia and hemodynamic normality. Some children with a terminal condition will have a standing "Do-Not-Resuscitate" order that should not necessarily be reversed. Surgeons, anesthesiologists, and family members must consider a number of factors when determining the appropriateness of an operation for a dying patient, including the rights of the child.
Santos
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KG
Division of Pediatric Surgery, Department of Surgery, University of Louisville and Kosair Children's Hospital, Louisville, KY, USA.
Fallat
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ME
D000293:Adolescent; D000758:Anesthesia; D002648:Child; D004992:Ethics, Medical; D013502:General Surgery; D006801:Humans; D008297:Male; D010166:Palliative Care; D016414:Resuscitation Orders; D013727:Terminal Care; D019452:Terminally Ill