What question did this study set out to answer?

To distinguish the ethical and clinical nuances between withholding and withdrawing life-sustaining interventions, such as CPR and mechanical ventilation, in moribund versus neurologically impaired infants in the NICU.

December 1, 2004PEDIATRICS

End-of-Life After Birth: Death and Dying in a Neonatal Intensive Care Unit

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Authors

JSJaideep SinghIndian Veterinary Research Institute JLJohn D. LantosBioethics International WMWilliam MeadowUniversity of Chicago

Discussion

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Implication

Retrospective cohort study reveals shifting patterns of life support withdrawal in dying newborns, highlighting distinct clinical scenarios beyond standard bioethics classifications.

Key Points

To distinguish the ethical and clinical nuances between withholding and withdrawing life-sustaining interventions, such as CPR and mechanical ventilation, in moribund versus neurologically impaired infants in the NICU.
Retrospective chart review of all newborn infants with birth weight >400 g who died at a single hospital during 1988, 1993, and 1998.
Extracted clinical and ethical variables including cardiopulmonary resuscitation, mechanical ventilation withdrawal, withholding of therapies, do-not-resuscitate orders, and neurologic prognosis.
Roughly half of all NICU deaths in 1993 and 1998 involved withholding or withdrawing treatment, with active withdrawal of ventilation reaching >40% of deaths by 1998.
Withholding CPR predominantly occurred in moribund infants already receiving ventilation and dopamine, whereas withdrawal of ventilation in physiologically stable infants for quality-of-life reasons occurred in 3% (1988), 16% (1993), and 13% (1998) of deaths, virtually never involving premature infants.
Median and average day of death did not differ significantly between non-survivors receiving full intervention (n=100) and non-survivors for whom intervention was withheld (n=78).

Cite This Study

Singh et al. (2004) studied this question.

synapsesocial.com/papers/6a96918ba45595e5080e2cb6 https://doi.org/10.1542/peds.2004-0447

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Implication

Retrospective cohort study reveals shifting patterns of life support withdrawal in dying newborns, highlighting distinct clinical scenarios beyond standard bioethics classifications.

End-of-Life After Birth: Death and Dying in a Neonatal Intensive Care Unit

Discussion

Member takes

Implication

Key Points

Cite This Study

End-of-Life After Birth: Death and Dying in a Neonatal Intensive Care Unit

Discussion

Member takes

Implication

Key Points

Cite This Study

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