Bobillo Pérez, SaraSegura Matute, SusanaGirona Alarcón, MònicaFelipe Villalobos, AidaBalaguer Gargallo, MònicaHernández Platero, LluisaSolé Ribalta, AnnaGuitart, CarminaJordán García, IolandaCambra Lasaosa, Francisco José2021-03-092021-03-092020-05-281472-684Xhttps://hdl.handle.net/2445/174832Background: The purpose of this paper is to describe how end-of-life care is managed when life-support limitationis decided in a Pediatric Intensive Care Unit and to analyze the influence of the further development of the Palliative Care Unit. Methods: A 15-year retrospective study of children who died after life-support limitation was initiated in a pediatric intensive care unit. Patients were divided into two groups, pre- and post-palliative care unit development. Epidemiological and clinical data, the decision-making process, and the approach were analyzed. Data was obtained from patient medical records. Results: One hundred seventy-five patients were included. The main reason for admission was respiratory failure (86/175). A previous pathology was present in 152 patients (61/152 were neurological issues). The medical team and family participated together in the decision-making in 145 cases (82.8%). The family made the request in 10 cases (9 vs. 1, p = 0.019). Withdrawal was the main life-support limitation (113/175), followed by withholding lifesustaining treatments (37/175). Withdrawal was more frequent in the post-palliative group (57.4% vs. 74.3%, p = 0.031). In absolute numbers, respiratory support was the main type of support withdrawn. Conclusions: The main cause of life-support limitation was the unfavourable evolution of the underlying pathology. Families were involved in the decision-making process in a high percentage of the cases. The development of the Palliative Care Unit changed life-support limitation in our unit, with differences detected in the type of patient and in the strategy used. Increased confidence among intensivists when providing end-of-life care, and the availability of a Palliative Care Unit may contribute to improvements in the quality of end-of-life care.8 p.application/pdfengcc-by (c) Bobillo Pérez, Sara et al., 2020http://creativecommons.org/licenses/by/3.0/esPediatria intensivaTractament pal·liatiuMortalitat infantilPediatric intensive carePalliative treatmentInfant mortalityinfo:eu-repo/semantics/article7032272021-03-09info:eu-repo/semantics/openAccess32466785