OBJECTIVE: To determine whether trends toward decreasing use of cardiopulmonary resuscitation at the time of death and increasing frequency of forgoing life-sustaining treatment had continued, as few studies quantifying mode of death for hospitalized infants have been conducted in the last 10 years. DESIGN: Retrospective descriptive study. SETTING: Regional referral neonatal intensive care unit. PARTICIPANTS: Infants who died from January 1, 1999, to December 31, 2008. Infants were categorized into following categories: (1) very preterm (≤32 weeks' gestation); (2) congenital anomaly; and (3) other. MAIN OUTCOME MEASURES: The primary outcome was level of clinical service provided at the end of life (care withheld, care withdrawn, or full resuscitation). RESULTS: For 10 years, 414 neonatal patients died. Of these, 61.6% had care withdrawn, 20.8% had care withheld, and 17.6% received cardiopulmonary resuscitation. The percentage of deaths that followed withholding of treatment rose by 1% per year (P = .01). Most of this change was accounted for by withholding of therapy in the very premature group. CONCLUSION: During the 10-year period, the primary mode of death in this regional referral neonatal intensive care unit was withdrawal of life-sustaining support. When death is imminent or medical care is considered futile, the approach is thought to provide a peaceful, controlled setting. Significant increase in withholding of care suggests improved recognition of medical futility and desire to provide a peaceful death.
OBJECTIVE: To determine whether trends toward decreasing use of cardiopulmonary resuscitation at the time of death and increasing frequency of forgoing life-sustaining treatment had continued, as few studies quantifying mode of death for hospitalized infants have been conducted in the last 10 years. DESIGN: Retrospective descriptive study. SETTING: Regional referral neonatal intensive care unit. PARTICIPANTS: Infants who died from January 1, 1999, to December 31, 2008. Infants were categorized into following categories: (1) very preterm (≤32 weeks' gestation); (2) congenital anomaly; and (3) other. MAIN OUTCOME MEASURES: The primary outcome was level of clinical service provided at the end of life (care withheld, care withdrawn, or full resuscitation). RESULTS: For 10 years, 414 neonatal patients died. Of these, 61.6% had care withdrawn, 20.8% had care withheld, and 17.6% received cardiopulmonary resuscitation. The percentage of deaths that followed withholding of treatment rose by 1% per year (P = .01). Most of this change was accounted for by withholding of therapy in the very premature group. CONCLUSION: During the 10-year period, the primary mode of death in this regional referral neonatal intensive care unit was withdrawal of life-sustaining support. When death is imminent or medical care is considered futile, the approach is thought to provide a peaceful, controlled setting. Significant increase in withholding of care suggests improved recognition of medical futility and desire to provide a peaceful death.
Authors: Monica E Lemmon; Renee D Boss; Sonia L Bonifacio; Audrey Foster-Barber; A James Barkovich; Hannah C Glass Journal: J Child Neurol Date: 2016-12-20 Impact factor: 1.987
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: Alison M Elliott; Christèle du Souich; Anna Lehman; Ilaria Guella; Daniel M Evans; Tara Candido; Leah Tooman; Linlea Armstrong; Lorne Clarke; William Gibson; Harinder Gill; Pascal M Lavoie; Suzanne Lewis; Margaret L McKinnon; Sarah M Nikkel; Millan Patel; Alfonso Solimano; Anne Synnes; Joseph Ting; Margot van Allen; Jan Christilaw; Matthew J Farrer; Jan M Friedman; Horacio Osiovich Journal: Eur J Pediatr Date: 2019-06-07 Impact factor: 3.183
Authors: Stephen F Kingsmore; Audrey Henderson; Mallory J Owen; Michelle M Clark; Christian Hansen; David Dimmock; Christina D Chambers; Laura L Jeliffe-Pawlowski; Charlotte Hobbs Journal: NPJ Genom Med Date: 2020-11-02 Impact factor: 8.617
Authors: Jonathan S Berg; Pankaj B Agrawal; Donald B Bailey; Alan H Beggs; Steven E Brenner; Amy M Brower; Julie A Cakici; Ozge Ceyhan-Birsoy; Kee Chan; Flavia Chen; Robert J Currier; Dmitry Dukhovny; Robert C Green; Julie Harris-Wai; Ingrid A Holm; Brenda Iglesias; Galen Joseph; Stephen F Kingsmore; Barbara A Koenig; Pui-Yan Kwok; John Lantos; Steven J Leeder; Megan A Lewis; Amy L McGuire; Laura V Milko; Sean D Mooney; Richard B Parad; Stacey Pereira; Joshua Petrikin; Bradford C Powell; Cynthia M Powell; Jennifer M Puck; Heidi L Rehm; Neil Risch; Myra Roche; Joseph T Shieh; Narayanan Veeraraghavan; Michael S Watson; Laurel Willig; Timothy W Yu; Tiina Urv; Anastasia L Wise Journal: Pediatrics Date: 2017-01-17 Impact factor: 7.124
Authors: Stephen F Kingsmore; Julie A Cakici; Michelle M Clark; Mary Gaughran; Michele Feddock; Sergey Batalov; Matthew N Bainbridge; Jeanne Carroll; Sara A Caylor; Christina Clarke; Yan Ding; Katarzyna Ellsworth; Lauge Farnaes; Amber Hildreth; Charlotte Hobbs; Kiely James; Cyrielle I Kint; Jerica Lenberg; Shareef Nahas; Lance Prince; Iris Reyes; Lisa Salz; Erica Sanford; Peter Schols; Nathaly Sweeney; Mari Tokita; Narayanan Veeraraghavan; Kelly Watkins; Kristen Wigby; Terence Wong; Shimul Chowdhury; Meredith S Wright; David Dimmock Journal: Am J Hum Genet Date: 2019-09-26 Impact factor: 11.025