Do not resuscitate orders in a Saudi pediatric intensive care unit.

OBJECTIVE To determine the percentage of deaths in the pediatric intensive care unit (PICU) attributed to do not resuscitate (DNR) orders, and to compare our DNR practice with the international experience. METHODS Retrospective chart review of all children less than 14 years of age who died in the PICU at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia from January 2007 to June 2009 (n=154). RESULTS The main mode of death was attributed to DNR orders in 79 cases (51%), failed cardiopulmonary resuscitation in 60 cases (39%), and brain death in 15 cases (10%). Of the 79 DNR orders, 46 (58%) were related to withdrawal of life support measures. CONCLUSION The DNR is the most common cause of death in the PICU in tertiary hospitals in Saudi Arabia. To minimize the suffering of the dying child, life support limitation should be considered for children with terminal or untreatable diseases with low chances of survival.