Comfort care of neonates at the end of life.

Most neonatal intensive care units have approaches to manage patients at the end of their lives. Published guidelines to help direct practitioners are lacking, and these management approaches, commonly referred to as comfort care, are often based on tradition. Recently, our neonatal staff experienced a unique situation that involved giving comfort care to a previable neonate who lived much longer than anticipated. Our staff identified the need for an evidence-based practice guideline to focus on four key care issues: provision of warmth, close physical contact, nutritional support, and sedation and pain management. The purpose of this article is to supply health care providers with evidence-based comfort care guidelines for neonates at the end of who either are previable of have had life support withdrawn. The process used for developing the guidelines is included.