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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Critical appraisal of: Triaging pediatric critical care resources during a pandemic: Ethical and medical considerations
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Critical appraisal of: Triaging pediatric critical care resources during a pandemic: Ethical and medical considerations

机译：重大评估：在大流行期间分流儿科重症监护资源：伦理和医学考虑

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Objective: To identify the ethical norms that should govern the allocation of pediatric critical care resources during a pandemic.Design: Narrative review.Methods: Review the literature on triage and pandemics.Findings: When care that is functionally equivalent to usual patient care practices can no longer be maintained, resources should be allocated primarily on the basis of medical need and/or benefit. Unequal treatment may be justified to increase the supply of available resources and thereby save more lives. When ethically relevant distinctions can no longer be made between patients, resources should be distributed by chance. Allocation on the basis of quality of life, general contributions to society, or age are potentially problematic. Existing triage protocols inconsistently articulate the relationship between these ethical norms and their specific recommendations. In addition, they have limited applicability in pediatrics principally because of the lack of a simple validated global scoring system, which predicts mortality and/or resource utilization.Conclusions: Although research to develop such scoring systems is ongoing, clinicians will need to rely more heavily on individual diagnoses of acute illnesses with high mortality rates and underlying conditions with short life expectancies and on random allocation methods.
机译：目的：确定大流行期间应控制儿科重症监护资源分配的道德规范设计：叙述性审查方法：审查分流和大流行的文献研究发现：在功能上可以等同于常规患者护理实践的护理可以不再维持，应主要根据医疗需要和/或利益分配资源。不公平的对待可能有理由增加可用资源的供应，从而挽救更多生命。当无法再在患者之间进行伦理上的区分时，应偶然分配资源。根据生活质量，对社会的总体贡献或年龄进行分配可能存在问题。现有分类标准协议不一致地阐明了这些道德规范与其具体建议之间的关系。此外，它们在儿科中的适用性有限，主要是因为缺乏一个简单的经过验证的全球评分系统，该系统可以预测死亡率和/或资源利用情况。结论：尽管正在进行此类评分系统的研究，但临床医生仍将需要更多的依赖单独诊断急性高死亡率和预期寿命短的潜在疾病，并采用随机分配方法。

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