Document Detail


Neonatal end-of-life practice in a German perinatal centre.
MedLine Citation:
PMID:  17462059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To investigate the end-of-life practice in a large perinatal centre in Germany. METHODS: Retrospective chart review was performed in all neonates deceased in the delivery room (n = 31) and the neonatal intensive care unit (n = 47) between 2002 and 2004. RESULTS: Neonatal death was preceded by an end-of-life decision (EOLD) in 81% of cases in the delivery room and 83% in the neonatal intensive care unit. The majority of deceased neonates were born prematurely or with congenital malformation. Life-sustaining treatment was not initiated in 74% of the infants deceased in the delivery room. In the unit, 52% died after withdrawal of therapy. Mechanical ventilation was withdrawn most frequently (79% of cases). Futility and immediate death were common considerations in EOLD, but the infant's suffering and future quality of life also played a role. Parents were involved in EOLD-making in all but emergency cases. No active termination of life was performed. CONCLUSION: In our perinatal centre, the majority of neonatal deaths occurred after limitation of therapy. Treatment was actively withdrawn in half of the infants in the neonatal intensive care unit. Actual end-of-life practice in a large perinatal centre differs from the restrictive attitude towards EOLD reported for German neonatologists in previous surveys.
Authors:
A Schulz-Baldes; D Huseman; A Loui; J W Dudenhausen; M Obladen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  96     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-27     Completed Date:  2007-06-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  681-7     Citation Subset:  IM    
Affiliation:
Institute for Biomedical Ethics, Zurich University Centre for Ethics, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Delivery Rooms / statistics & numerical data*
Female
Germany
Gestational Age
Humans
Infant Mortality*
Infant, Newborn
Intensive Care Units, Neonatal / statistics & numerical data*
Logistic Models
Male
Medical Audit
Medical Futility
Neonatology
Quality of Life
Respiration, Artificial
Retrospective Studies
Terminal Care*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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