Futility of Ventilation for Children with Severe Neurological Impairment

In the May 2010 issue of Developmental Medicine & Child Neurology, Van Gestel and colleagues in the Netherlands look at ICU admissions of children with severe neurological impairment admitted for respiratory failure.  They found that just 1% had an uneventful 1-year survival (weaning, extubation, discharge, and no readmission to ICU).  Still, they conclude:  "Repeated, prolonged, and complicated admission to the ICU was often required.  However, outcome was not uniformly dismal, which underscores the urgent need for further research for the rational guidance of clinical decision-making in this population."