• Matteo Martinato, Rosanna I Comoretto, Paolo Biban, Elisa Zanonato, Alessandro Simonini, Alessia Montaguti, Eloisa Gitto, Fabio Caramelli, Stefania Ferrario, Raffaella Sagredini, Nicola Alaimo, Geremia Zito Marinosci, Emanuele Rossetti, Corrado Cecchetti, Manuela L'erario, Beatrice Vasile, Giorgio Ivani, Ezio Bonanomi, Marinella Astuto, Dario Gregori, Maria C Mondardini, Angela Amigoni, and OncoTIPnet Study Group.
• Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
• Minerva Anestesiol. 2023 Oct 1; 89 (10): 850858850-858.

BackgroundPediatric patients affected by oncologic disease have a significant risk of clinical deterioration that requires admission to the intensive care unit. This study reported the results of a national survey describing the characteristics of Italian onco-hematological units (OHUs) and pediatric intensive care units (PICUs) that admit pediatric patients, focusing on the high-complexity treatments available before PICU admission, and evaluating the approach to the end-of-life (EOL) when cared in a PICU setting.MethodsA web-based electronic survey has been performed in April 2021, involving all Italian PICUs admitting pediatric patients with cancer participating in the study.ResultsEighteen PICUs participated, with a median number of admissions per year of 350 (IQR 248-495). Availability of Extracorporeal Membrane Oxygenation therapy and the presence of intermediate care unit are the only statistically different characteristics between large or small PICUs. Different high-level treatments and protocols are performed in OHUs, non depending on the volume of PICU. Palliative sedation is mainly performed in the OHUs (78%), however, in 72% it is also performed in the PICU. In most centers protocols that address EOL comfort care and treatment algorithms are missing, non depending on PICU or OHU volume.ConclusionsA non-homogeneous availability of high-level treatments and in OHUs is described. Moreover, protocols addressing EOL comfort care and treatment algorithms in palliative care are lacking in many centers.

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