{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:18:00Z","timestamp":1787761080015,"version":"build-2784847793"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    National guidelines recommend the opportunity to reconsider existing Do\u2010Not\u2010Resuscitate (DNR) orders periprocedurally rather than automatic suspension of DNR orders. We retrospectively reviewed records for oncology patients with active DNR orders presenting for anesthesia between 2023 and 2025. Twenty patients (mean age 12\u00a0years; 60% male) underwent 41 procedures: radiation (43%), imaging (22%), interventional radiology (20%), and surgery (15%). DNR orders were suspended in 85.3% of procedures and maintained in 14.7%. No significant association existed between procedure type and DNR status (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.4). No cardiopulmonary arrest events occurred. Documentation of communication regarding DNR reconsideration occurred in one perioperative encounter. Findings highlight clinical opportunities to improve periprocedural communication processes.\n                  <\/jats:p>","DOI":"10.1002\/1545-5017.70430","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T02:47:11Z","timestamp":1785379631000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Required Reconsideration of Periprocedural Resuscitation Status: Can Ethics Principles Inform Institutional Practice?"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-5627-4536","authenticated-orcid":false,"given":"Rachel","family":"Jalfon","sequence":"first","affiliation":[{"name":"Division of Palliative Care, Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2310-0111","authenticated-orcid":false,"given":"Meaghann S.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Division of Palliative Care, Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Bioethics Program St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deena R.","family":"Levine","sequence":"additional","affiliation":[{"name":"Division of Palliative Care, Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Bioethics Program St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankari","family":"Kalyanasundaram","sequence":"additional","affiliation":[{"name":"Analytic Services Information Services, St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Guess","sequence":"additional","affiliation":[{"name":"Clinical Applications Information Services, St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7124-979X","authenticated-orcid":false,"given":"Liza\u2010Marie","family":"Johnson","sequence":"additional","affiliation":[{"name":"Bioethics Program St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8614-3912","authenticated-orcid":false,"given":"Michael","family":"Frett","sequence":"additional","affiliation":[{"name":"Division of Anesthesia, Department of Pediatrics St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzipa","family":"Zweig","sequence":"additional","affiliation":[{"name":"Division of Anesthesia, Department of Pediatrics St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"American Society of Anesthesiologists \u201cStatement on Ethical Guidelines for the Anesthesia Care of Patients With Do\u2010Not\u2010Resuscitate Orders \u201dAmerican Society of Anesthesiologists 2023 https:\/\/www.asahq.org\/standards\u2010and\u2010practice\u2010parameters\/statement\u2010on\u2010ethical\u2010guidelines\u2010for\u2010the\u2010anesthesia\u2010care\u2010of\u2010patients\u2010with\u2010do\u2010not\u2010resuscitate\u2010orders."},{"key":"e_1_2_9_3_1","unstructured":"The American College of Surgeons \u201cStatement on Advance Directives by Patients: \"Do Not Resuscitate\" in the Operating Room \u201dThe American College of Surgeons 2014 https:\/\/www.facs.org\/about\u2010acs\/statements\/advance\u2010directives\u2010by\u2010patients\u2010do\u2010not\u2010resuscitate\u2010in\u2010the\u2010operating\u2010room\/."},{"key":"e_1_2_9_4_1","unstructured":"Associatoin of PeriOperative Registered Nurses (AORN) \u201cPosition Statement on Perioperative Care of Patients With Do\u2010Not\u2010Resuscitate or Allow\u2010Natural\u2010Death Orders \u201dAORN 2020 https:\/\/www.aorn.org\/docs\/default\u2010source\/guidelines\u2010resources\/position\u2010statements\/patient\u2010care\/posstat\u2010dnr\u2010w\u20100620.pdf?sfvrsn=b4a9796d_1."},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2253-13-2"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000974"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/XCS.0000000000000116"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2009.03082.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.10.007"},{"key":"e_1_2_9_10_1","first-page":"971","article-title":"Pediatric Perioperative DNR Orders: A Case Series in a Children's Hospital","volume":"57","author":"Brown S. E. S.","year":"2019","journal-title":"J"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2025.109822"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000005107"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018-0598"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0000000000000860"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000000873"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969733019857781"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70430","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/1545-5017.70430","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/1545-5017.70430","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:18:56Z","timestamp":1787757536000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/1545-5017.70430"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,29]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/1545-5017.70430"],"URL":"https:\/\/doi.org\/10.1002\/1545-5017.70430","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,29]]},"assertion":[{"value":"2026-01-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-15","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70430"}}