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Noninvasive Ventilation in Palliative Care and Ethical Dilemma
Significant difference exists between validated indications for noninvasive ventilation (NIV) use in children and current real life practice. Lately, dedicated centers have reported exponential growth of NIV use in children and adolescents. Upper airway obstruction, neuromuscular diseases, chronic l...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493667/ https://www.ncbi.nlm.nih.gov/pubmed/33014921 http://dx.doi.org/10.3389/fped.2020.00483 |
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author | Krivec, Uros Caggiano, Serena |
author_facet | Krivec, Uros Caggiano, Serena |
author_sort | Krivec, Uros |
collection | PubMed |
description | Significant difference exists between validated indications for noninvasive ventilation (NIV) use in children and current real life practice. Lately, dedicated centers have reported exponential growth of NIV use in children and adolescents. Upper airway obstruction, neuromuscular diseases, chronic lung/thoracic conditions, and central respiratory drive failure remain the most prevalent indications. However, the need to alleviate respiratory failure related distress has been increasingly recognized in several other conditions. Palliative care in children with life limiting disorders is a complex continuum of activities. In order to provide the most appropriate care for the patients and their families, the management often oscillates between actively curative and purely supportive actions. Despite unprecedented therapeutic advancements, several neurologic, metabolic, hemato-oncologic, respiratory, and other rare diseases remain with no curative options. Besides, attentiveness to relive suffering, awareness, and availability have moved the boundaries of NIV use toward conditions formerly not considered suitable for such care. Still, NIV has limitations and can, if sustained in inappropriate circumstances, fail to provide relief. A structured professional frameshift should be available for support and ethical guidance in order to provide confidence to patients, families and all the involved caregivers. |
format | Online Article Text |
id | pubmed-7493667 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74936672020-10-02 Noninvasive Ventilation in Palliative Care and Ethical Dilemma Krivec, Uros Caggiano, Serena Front Pediatr Pediatrics Significant difference exists between validated indications for noninvasive ventilation (NIV) use in children and current real life practice. Lately, dedicated centers have reported exponential growth of NIV use in children and adolescents. Upper airway obstruction, neuromuscular diseases, chronic lung/thoracic conditions, and central respiratory drive failure remain the most prevalent indications. However, the need to alleviate respiratory failure related distress has been increasingly recognized in several other conditions. Palliative care in children with life limiting disorders is a complex continuum of activities. In order to provide the most appropriate care for the patients and their families, the management often oscillates between actively curative and purely supportive actions. Despite unprecedented therapeutic advancements, several neurologic, metabolic, hemato-oncologic, respiratory, and other rare diseases remain with no curative options. Besides, attentiveness to relive suffering, awareness, and availability have moved the boundaries of NIV use toward conditions formerly not considered suitable for such care. Still, NIV has limitations and can, if sustained in inappropriate circumstances, fail to provide relief. A structured professional frameshift should be available for support and ethical guidance in order to provide confidence to patients, families and all the involved caregivers. Frontiers Media S.A. 2020-08-27 /pmc/articles/PMC7493667/ /pubmed/33014921 http://dx.doi.org/10.3389/fped.2020.00483 Text en Copyright © 2020 Krivec and Caggiano. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Krivec, Uros Caggiano, Serena Noninvasive Ventilation in Palliative Care and Ethical Dilemma |
title | Noninvasive Ventilation in Palliative Care and Ethical Dilemma |
title_full | Noninvasive Ventilation in Palliative Care and Ethical Dilemma |
title_fullStr | Noninvasive Ventilation in Palliative Care and Ethical Dilemma |
title_full_unstemmed | Noninvasive Ventilation in Palliative Care and Ethical Dilemma |
title_short | Noninvasive Ventilation in Palliative Care and Ethical Dilemma |
title_sort | noninvasive ventilation in palliative care and ethical dilemma |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7493667/ https://www.ncbi.nlm.nih.gov/pubmed/33014921 http://dx.doi.org/10.3389/fped.2020.00483 |
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