Physicians' attitudes when faced with life-threatening events in children with severe neurological disabilities.

ARTIFICIAL respiration; ATTITUDE (Psychology); CARDIOPULMONARY resuscitation; HEALTH care teams; INTENSIVE care units; LIFE; LIFE change events; MEDICAL care; PEOPLE with intellectual disabilities; NEUROLOGICAL disorders; PATIENTS; PEDIATRICS; QUESTIONNAIRES; SPINAL muscular atrophy; SURVEYS; TRACHEOTOMY; DECISION making in clinical medicine; DISABILITIES; PHYSICIANS' attitudes; CHILDREN

Purpose: Children with severe neurological disabilities are at an increased risk of acute, life-threatening events. We assessed physicians' attitudes when making decisions in these situations. Methods: We surveyed physicians in pediatric intensive care, neurology, and rehabilitation units in Swiss hospitals. The questionnaire explored participants' attitudes toward life-threatening situations in two scenarios: a child with profound intellectual and multiple disabilities (PIMD) and an infant with spinal muscular atrophy (SMA) type I. Results: The participation rate was 55% (52/95). There was a consensus favoring non-invasive ventilation and comfort care as well as avoiding tracheostomy and invasive ventilation. For the child with PIMD, 61% of participants opposed cardiopulmonary resuscitation (CPR), 51% for the child with SMA. Physicians with over 20 years of experience were significantly more opposed to providing CPR than less experienced colleagues. Conclusions: Physicians held different views, influenced by personal factors. This highlights the importance of standardizing multidisciplinary processes toward approaching these complex situations. [ABSTRACT FROM AUTHOR]