Document Detail


Decision making and modes of death in a tertiary neonatal unit.
MedLine Citation:
PMID:  15499147     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To study the frequency and reason for withdrawal/withholding of life sustaining treatment (LST) and do not resuscitate (DNR) orders in infants who died in a tertiary neonatal unit. METHODS: Infants who died at Homerton University Hospital between January 1998 and September 2001 were studied by retrospective analysis of patient records. RESULTS: The case notes of 71 (84%) of 85 infants who died were studied. Mode of death was withdrawal of LST in 28 (40%), DNR in 11 (15%), withholding of LST in two (3%), and natural in 30 (42%) infants. Withdrawal of LST was discussed with the parents of 39 seriously ill infants; 28 (72%) parents agreed. There was no difference in birth weight and gestational age of babies whose parents agreed or refused withdrawal of LST. White and Afro-Caribbean parents and those from the Indian subcontinent (20 of 23) were more likely to agree to withdrawal of LST than Black African or Jewish (eight of 16, p = 0.015) parents. The median age at withdrawal of LST was 4 days (range 1-57). The median duration between discussion and the parents agreeing to withdrawal of LST was 165 minutes (range 30-2160), and median duration between withdrawal of LST and death was 22 minutes (range 5-210). The most common reason for withdrawal of LST was complications of extreme prematurity (68%). CONCLUSION: The most common mode of death was withdrawal of LST, and the most common reason was complications of extreme prematurity. The ethnic and cultural background of the parents influenced agreement to withdrawal of LST.
Authors:
R Roy; N Aladangady; K Costeloe; V Larcher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  89     ISSN:  1359-2998     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-22     Completed Date:  2004-11-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F527-30     Citation Subset:  AIM; E; IM    
Affiliation:
Homerton University Hospital, London E9 6SR, UK.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Birth Weight
Decision Making / ethics*
Female
Gestational Age
Humans
Infant, Newborn
Infant, Newborn, Diseases / therapy*
Life Support Care / ethics
Male
Parents / psychology
Resuscitation Orders / ethics*
Retrospective Studies
Withholding Treatment / ethics*
Comments/Corrections

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