Document Detail

Treatment choices for extremely preterm infants: an international perspective.
MedLine Citation:
PMID:  11060524     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To compare treatment choices of neonatal physicians and nurses in 11 European countries for a hypothetical case of extreme prematurity (24 weeks' gestational age, birth weight of 560 g, Apgar score of 1 at 1 minute). STUDY DESIGN: An anonymous, self-administered questionnaire was completed by 1401 physicians (response rate, 89%) and 3425 nurses (response rate, 86%) from a large, representative sample of 143 European neonatal intensive care units. Italy, Spain, France, Germany, the Netherlands, Luxembourg, Great Britain, Sweden, Hungary, Estonia, and Lithuania participated. RESULTS: Most physicians in every country but the Netherlands would resuscitate this baby and start intensive care. On subsequent deterioration of clinical conditions caused by a severe intraventricular hemorrhage, attitudes diverge: most neonatologists in Germany, Italy, Estonia, and Hungary would favor continuation of intensive care, whereas in the other countries some form of limitation of treatment would be the preferred choice. Parental wishes appear to play a role especially in Great Britain and the Netherlands. Nurses are more prone than doctors to withhold resuscitation in the delivery room and to ask parental opinion regarding subsequent treatment choices. CONCLUSION: An extremely premature infant is regarded as viable by most physicians, whereas after deterioration of the clinical conditions decision-making patterns vary according to country. These findings have implications for the ethical debate surrounding treatment of infants of borderline viability and for the interpretation and comparison of international statistics.
R De Leeuw; M Cuttini; M Nadai; I Berbik; G Hansen; A Kucinskas; S Lenoir; A Levin; J Persson; M Rebagliato; M Reid; M Schroell; U de Vonderweid;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  137     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-05     Completed Date:  2000-12-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  608-16     Citation Subset:  AIM; E; IM    
Department of Neonatology, Amsterdam University, Amsterdam, The Netherlands.
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MeSH Terms
Decision Making*
Ethics, Medical*
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / therapy*
Intensive Care, Neonatal*
Middle Aged
Nurses / psychology
Physician's Practice Patterns*
Physicians / psychology
Resuscitation* / psychology
Comment In:
J Pediatr. 2000 Nov;137(5):593-5   [PMID:  11060518 ]

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

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