Integrating palliative care into the PICU: A report from the improving palliative care in the ICU advisory board

Renee Boss, Judith Nelson, David Weissman, Margaret Campbell, Randall Curtis, Jennifer Frontera, Michelle Gabriel, Dana Lustbader, Anne Mosenthal, Colleen Mulkerin, Kathleen Puntillo, Daniel Ray, Rick Bassett, Karen Brasel, Ross Hays

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


Objective: This review highlights benefits that patients, families and clinicians can expect to realize when palliative care is intentionally incorporated into the PICU.

Data Sources: We searched the MEDLINE database from inception to January 2014 for English-language articles using the terms "palliative care" or "end of life care" or "supportive care" and "pediatric intensive care." We also hand-searched reference lists and author files and relevant tools on the Center to Advance Palliative Care website.

Study Selection: Two authors (physicians with experience in pediatric intensive care and palliative care) made final selections.

Data Extraction: We critically reviewed the existing data and tools to identify strategies for incorporating palliative care into the PICU.

Data Synthesis: The Improving Palliative Care in the ICU Advisory Board used data and experience to address key questions relating to: pain and symptom management, enhancing quality of life, communication and decision-making, length of stay, sites of care, and grief and bereavement.

Conclusions: Palliative care should begin at the time of a potentially life-limiting diagnosis and continue throughout the disease trajectory, regardless of the expected outcome. Although the PICU is often used for short term postoperative stabilization, PICU clinicians also care for many chronically ill children with complex underlying conditions and others receiving intensive care for prolonged periods. Integrating palliative care delivery into the PICU is rapidly becoming the standard for high quality care of critically ill children. Interdisciplinary ICU staff can take advantage of the growing resources for continuing education in pediatric pal- liative care principles and interventions. (Pediatr Crit Care Med 2014; 15:762-767).

Original languageEnglish (US)
Pages (from-to)762-767
Number of pages6
JournalPediatric Critical Care Medicine
Issue number8
StatePublished - Oct 10 2014
Externally publishedYes


  • Communication
  • Decision making
  • End-of-life
  • Pain management
  • Palliative care
  • Pediatric

ASJC Scopus subject areas

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


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