What Pediatric Palliative Care Offers to Pediatric Surgeons

Space: StayCurrentMD Author: Sarah J. Halix, Amy S. Porter, Alexandria J. Robbins, Lisa VanHouwelingen, Ryan M. Antiel, Hau D. Le, Reto M. Baertschiger, Danielle B. Cameron Published:

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Sarah J. Halix, Amy S. Porter, Alexandria J. Robbins, Lisa VanHouwelingen, Ryan M. Antiel, Hau D. Le, Reto M. Baertschiger, Danielle B. Cameron

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Imagine caring for Harmony, a mono–mono twin girl born emergently via C-section at 30 weeks gestation. Prenatal work-up suggested an anorectal malformation and cystic pelvic kidneys. At delivery, she was found to have a cloaca and non-functioning kidneys; she had survived in utero because her twin had effectively acted as her dialysis machine. The pediatric surgery team was consulted to consider colostomy and hemodialysis line placement – a technical feat in this 1.2 kg baby. How might you guide this family through decision-making that aligns with their goals and values?

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