International perspectives on pediatric palliative care: Mexico.

The safe keeping of children and families that require Pediatric Palliative Care (PPC), presents a challenge to the healthcare professionals and systems, particularly in countries like Mexico. This is due to social inequities, the cultural diversity, the geo-regional position that determine specific social dynamics and nowadays the huge immigration issues that we are facing. The combination of all these factors, requires a vast knowledge from PPC providers about the necessary tools to properly provide the support needed in the most effective and efficient way, based on compassion. Knowing how to accurately understand the needs of children and their families requiring PPC and how to best assist them during the decision-making process is extremely important. At the same time, all PPC team members require expertise in addressing pediatric pathophysiology and bioethical issues that apply to diverse and heterogeneous age groups.

Palliative Care in Pediatric Pulmonology.

Children with End Stage Lung Disease (ESLD) are part of the growing population of individuals with life-limiting conditions of childhood. These patients present with a diverse set of pulmonary, cardiovascular, neuromuscular, and developmental conditions. This paper first examines five cases of children with cystic fibrosis, bronchopulmonary dysplasia, neuromuscular disease, pulmonary hypertension, and lung transplantation from Texas Children's Hospital. We discuss the expected clinical course of each condition, then review the integration of primary and specialized palliative care into the management of each diagnosis. This paper then reviews the management of two children with end staged lung disease at Hospital Civil de Guadalajara, providing an additional perspective for approaching palliative care in low-income countries.