BACKGROUND: Death remains a common event in the neonatal intensive care unit, and often involves limitation or withdrawal of life sustaining treatment. OBJECTIVE: To document changes in the causes of death and its management over the last two decades. METHODS: An audit of infants dying in the neonatal intensive care unit was performed during two epochs (1985-1987 and 1999-2001). The principal diagnoses of infants who died were recorded, as well as their apparent prognoses, and any decisions to limit or withdraw medical treatment. RESULTS: In epoch 1, 132 infants died out of 1362 admissions (9.7%), and in epoch 2 there were 111 deaths out of 1776 admissions (6.2%; p<0.001). Approximately three quarters of infants died after withdrawal of life sustaining treatment in both epochs. There was a significant reduction in the proportion of deaths from chromosomal abnormalities, and from neural tube defects in epoch 2. CONCLUSIONS: There have been substantial changes in the illnesses leading to death in the neonatal intensive care unit. These may reflect the combined effects of prenatal diagnosis and changing community and medical attitudes.
BACKGROUND:Death remains a common event in the neonatal intensive care unit, and often involves limitation or withdrawal of life sustaining treatment. OBJECTIVE: To document changes in the causes of death and its management over the last two decades. METHODS: An audit of infants dying in the neonatal intensive care unit was performed during two epochs (1985-1987 and 1999-2001). The principal diagnoses of infants who died were recorded, as well as their apparent prognoses, and any decisions to limit or withdraw medical treatment. RESULTS: In epoch 1, 132 infants died out of 1362 admissions (9.7%), and in epoch 2 there were 111 deaths out of 1776 admissions (6.2%; p<0.001). Approximately three quarters of infants died after withdrawal of life sustaining treatment in both epochs. There was a significant reduction in the proportion of deaths from chromosomal abnormalities, and from neural tube defects in epoch 2. CONCLUSIONS: There have been substantial changes in the illnesses leading to death in the neonatal intensive care unit. These may reflect the combined effects of prenatal diagnosis and changing community and medical attitudes.
Authors: Laurel K Willig; Josh E Petrikin; Laurie D Smith; Carol J Saunders; Isabelle Thiffault; Neil A Miller; Sarah E Soden; Julie A Cakici; Suzanne M Herd; Greyson Twist; Aaron Noll; Mitchell Creed; Patria M Alba; Shannon L Carpenter; Mark A Clements; Ryan T Fischer; J Allyson Hays; Howard Kilbride; Ryan J McDonough; Jamie L Rosterman; Sarah L Tsai; Lee Zellmer; Emily G Farrow; Stephen F Kingsmore Journal: Lancet Respir Med Date: 2015-04-27 Impact factor: 30.700
Authors: Erica F Sanford; Michelle M Clark; Lauge Farnaes; Matthew R Williams; James C Perry; Elizabeth G Ingulli; Nathaly M Sweeney; Ami Doshi; Jeffrey J Gold; Benjamin Briggs; Matthew N Bainbridge; Michele Feddock; Kelly Watkins; Shimul Chowdhury; Shareef A Nahas; David P Dimmock; Stephen F Kingsmore; Nicole G Coufal Journal: Pediatr Crit Care Med Date: 2019-11 Impact factor: 3.624
Authors: April R Dworetz; Girija Natarajan; John Langer; Kathy Kinlaw; Jennifer R James; Margarita Bidegain; Abhik Das; Brenda Poindexter; Edward F Bell; C M Cotten; Haresh Kirpalani; Seetha Shankaran; Barbara J Stoll Journal: Arch Dis Child Fetal Neonatal Ed Date: 2020-10-20 Impact factor: 5.747