| Whom are We Comforting? An Analysis of Comfort Medications Delivered to Dying Neonates. | |
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MedLine Citation:
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PMID: 21353679 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: To clarify the use of end-of-life comfort medications or neuromuscular blockers (NMBs) in culturally different neonatal intensive care units (NICUs). STUDY DESIGN: Review of medical files of newborns > 22 weeks gestation who died in the delivery room or the NICU during 12 months in four NICUs (Chicago, Milwaukee, Montreal, and Groningen). We compared use of end-of-life comfort medications and NMBs. RESULTS: None of the babies who died in the delivery room received comfort medications. The use of opiods (77%) or benzodiazepines (41%) around death was similar in all NICUs. Increasing this medication around extubation occurred most often in Montreal, rarely in Milwaukee and Groningen, and never in Chicago. Comfort medications use had no significant impact on the time between extubation and death. NMBs were never used around death in Chicago, once in Montreal, and more frequently in Milwaukee and Groningen. Initiation of NMB after extubation occurred only in Groningen. CONCLUSION: Comfort medications were administered to almost all dying infants in each NICU. Some, but not all, centers were comfortable increasing these medications around or after extubation. In three centers, NMBs were at times present at the time of death. However, only in Holland were NMBs initiated after extubation. |
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Authors:
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Annie Janvier; William Meadow; Steven R Leuthner; Bree Andrews; Joanne Lagatta; Arend Bos; Laura Lane; A A Eduard Verhagen |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-24 |
Journal Detail:
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Title: The Journal of pediatrics Volume: - ISSN: 1097-6833 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375410 Medline TA: J Pediatr Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Mosby, Inc. All rights reserved. |
Affiliation:
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Pediatrics and Clinical Ethics, Université de Montréal, Montréal, Québec, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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