title: [To maintain or to withdraw life support? Variations on the methods of ending life in a pediatric intensive care unit over a period of 6 years].
abstract: Since 2005, forgoing live-support (FLS) is allowed by the French law (known as the Leonetti law) for end-of-life patients only. This study aims at describing the variations over time in the use of the following methods to end life: FLS, brain death and cardiopulmonary resuscitation failure (CPR failure). It is a single retrospective study from 2007 to 2012. The Cochran-Armitage trend test is used in the statistical analysis. Over six years, 263 of the 5100 children who were hospitalized in our intensive care unit died, which represents a 5.2% mortality rate. FLS increased yearly from 31% of the deaths in 2007, to 71% in 2012 (P=0.0008). The rate of CPR failure decreased over the same period (P=0.0015). The rate of brain death remained constant. Following to the Leonetti law, FLS increase, and palliative cares develop without any increase of mortality.
authors.affiliation: Service de réanimation pédiatrique, hôpital de la Timone, faculté de médecine, université Aix-Marseille, 27, boulevard Jean-Moulin, 13005 Marseille, France. Electronic address: samuel.vernaz@laposte.net.
authors.forename: S
authors.initials: S
authors.lastname: Vernaz
authors.affiliation: Département de médecine générale, Aix-Marseille université, 27, boulevard Jean-Moulin, 13005, Marseille, France.
authors.forename: L
authors.initials: L
authors.lastname: Casanova
authors.affiliation: Service de réanimation pédiatrique, hôpital de la Timone, faculté de médecine, université Aix-Marseille, 27, boulevard Jean-Moulin, 13005 Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Blanc
authors.affiliation: Service de réanimation pédiatrique, hôpital de la Timone, faculté de médecine, université Aix-Marseille, 27, boulevard Jean-Moulin, 13005 Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Lebel
authors.affiliation: Service de réanimation pédiatrique, hôpital de la Timone, faculté de médecine, université Aix-Marseille, 27, boulevard Jean-Moulin, 13005 Marseille, France.
authors.forename: F
authors.initials: F
authors.lastname: Ughetto
authors.affiliation: Service de réanimation pédiatrique, hôpital de la Timone, faculté de médecine, université Aix-Marseille, 27, boulevard Jean-Moulin, 13005 Marseille, France.
authors.forename: O
authors.initials: O
authors.lastname: Paut
mesh_terms: D001926:Brain Death; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000941:ethics / Q000592:standards; D005260:Female; D005602:France; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007883:Legislation, Medical; D008020:Life Support Care / Q000941:ethics / Q000331:legislation & jurisprudence / Q000592:standards*; D008297:Male; D010166:Palliative Care; D010372:Pediatrics / Q000941:ethics / Q000331:legislation & jurisprudence / Q000592:standards*; D016414:Resuscitation Orders; D017211:Treatment Failure; D028761:Withholding Treatment / Q000941:ethics / Q000331:legislation & jurisprudence / Q000592:standards*
keywords: Death; Décès; End-of-life; Fin de vie; Forgoing live-support; Limitation et arrêt des thérapeutiques actives; Pediatric intensive care unit; Réanimation pédiatrique; Withholding or withdrawing life-sustaining treatments