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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Palliative Care 1/2015

Paediatric palliative care: recommendations for treatment of symptoms in the Netherlands

BMC Palliative Care > Ausgabe 1/2015
Rutger R. G. Knops, Leontien C. M. Kremer, A. A. Eduard Verhagen, on behalf of the Dutch Paediatric Palliative Care Guideline Group for Symptoms
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12904-015-0054-7) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

RK acquired, analysed and interpreted the data, drafted the initial manuscript, and approved the final manuscript as submitted. LK and EV conceptualized and designed the study, coordinated and supervised data collection, critically reviewed the manuscript, and approved the final manuscript as submitted. All authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.



Children dying of a life threatening disease suffer a great deal at the end of life. Symptom control is often unsatisfactory, partly because many caregivers are simply not familiar with paediatric palliative care. To ensure that a child with a life-threatening condition receives high quality palliative care, clinical practice guidelines are needed. The aim of this study is to improve palliative care for children by making high quality care recommendations to recognize and relieve symptoms in paediatric palliative care.


An extensive search was performed for guidelines and systematic reviews on paediatric palliative care up to year 2011. An expert panel combined the evidence with consensus to form recommendations on the treatment of symptoms in paediatric palliative care.


We appraised 21 guidelines and identified 693 potentially eligible articles of which four met our inclusion criteria. None gave recommendations on the treatment of symptoms in paediatric palliative care. Two textbooks and an adult palliative care website were eventually our main sources of evidence.


Hardly any evidence is available for the treatment of symptoms in paediatric palliative care. By combining evidence for adult palliative care and the sparse evidence for paediatric palliative care with expert opinion we defined a unique set of high quality care recommendations to relieve symptoms and lessen the suffering of children in palliative care. These results are an important tool to educate caregivers on how to relieve symptoms in children in paediatric palliative care.
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