Optimizing ICU Care and Decision-Making for Children and AYAs With Severe Neurologic Impairment

Concurrent Session Moderator(s)

• 

  Sabrina Derrington, MD, MA Bioethics (she/her/hers)

  Associate Professor of Pediatrics; Director, CHLA Center for Bioethics
  Childrens Hospital Los Angeles
  La Canada Flt, California

Patients with severe neurologic impairment (SNI) represent a disproportionate percentage of pediatric ICU patients, with frequent readmissions and long hospitalizations. SNI etiologies vary and can include genetic disorders, congenital abnormalities, infections, or environmental problems such as traumatic brain injury. The heterogeneity of SNI causes, medical complexity, and chronic dependence on medical technology pose challenges in managing complications of SNI and are barriers to accurate prognostication and to informed decision-making. This session will explore optimizing care for children with SNI, including characterization and prognostication, assessment of pain behaviors and symptom management for spasticity, status dystonicus, and paroxysmal sympathetic hyperactivity, as well as ethical considerations for decision-making.

Presentations:

• One Size Does Not Fit All: Characterization and Prognostication in Severe Neurologic Impairment
• Weathering the Storm: What's New in the Treatment of Paroxysmal Sympathetic Hyperactivity, Neuropathic Pain, Spasticity, and Dystonia
• How Much Is Too Much? Ethical Considerations and Decision-Making in Pediatric Critical Care Neurology