Authors (including presenting author) :
SL Ng(1), SS Man(1), E Leung(2), N Chan(3), J Tsang(4), Karen KY Leung (1)
Affiliation :
(1)Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital (2)Medical Social Service Unit, Hong Kong Children's Hospital (3)Clinical Psychology, Kowloon Hospital (4)Nursing Department, Hong Kong Children's Hospital
Keyword 1: :
Paediatric Palliative Care
Keyword 2: :
Paediatric Intensive Care Unit
Keyword 3: :
End-of-Life Care
Keyword 4: :
Do Not Resuscitate Orders
Keyword 5: :
Referral and Consultation
Introduction :
Palliative care in the paediatric intensive care unit (PICU) prioritises on symptom management, family support, and end-of-life planning for children with life-limiting conditions. There are studies point out that utilisation of palliative care services in PICU is not adequate1,2,3. At Hong Kong Children's Hospital (HKCH), palliative care services integrate multidisciplinary teams, yet utilisation in acute PICU settings remains understudied, with potential gaps in timely referrals amid curative priorities.
Objectives :
To evaluate the delivery of palliative care in PICU deaths, including referral rates, timing, indications, end-of-life support, and do-not-resuscitate (DNR) decisions, stratified by diagnostic categories.
Methodology :
A retrospective review of 30 PICU deaths at HKCH PICU from January 2024 to August 2025 was performed. Data included demographics, length of stay, diagnosis (oncology, cardiology, infection, others), paediatric palliative care team (PPC) referral timing and indications, end-of-life (EOL) support, and DNR status.
Result & Outcome :
Palliative care was well integrated in HKCH PICU, with high referral rates and good EOL supports. High integration was due to high vigilance of the PICU team and the availability of PPC for 24/7 EOL supports for referred cases. Identified service gaps include missed referrals in short admissions, delayed referrals, lack of standardized psychological protocols for acute deterioration, and prolonged PICU stays. Future enhancements could include standardized psychological screening protocols for acute cases and measures to facilitate palliative cases to be discharged from PICU.
