Neonatal hypoxic-ischaemic encephalopathy: most deaths followed end-of-life decisions within three days of birth.
Acta Paediatr
; 102(12): 1137-43, 2013 Dec.
Article
em En
| MEDLINE
| ID: mdl-24102859
ABSTRACT
AIM:
To investigate the circumstances surrounding end-of life decisions (EoL) of infants with hypoxic-ischaemic encephalopathy (HIE) and examine changes over a 10-year period.METHODS:
Retrospective chart review of all infants with HIE who died during 2000-2004 and 2005-2009 in a Level III Neonatal Intensive Care Unit in Madrid, Spain.RESULTS:
Of 70 infants with HIE, 18 died during the neonatal period. The mean age of death was 64.4 ± 51 h. In 17 of the 18 infants (94%), death was preceded by an EoL decision, four after withholding therapy (WH) and 13 after withdrawal therapy (WDT). All infants with WH were previously stable and without respiratory support, while all 13 infants in the WDT group had respiratory support and three were unstable. The age of death was greater in the WH group than the WDT group (122 ± 63 h vs 50 ± 34; p < 0.001). After the EoL decision, 11 (65%) infants received sedatives. There were no differences between the time periods.CONCLUSION:
In our cohort, most deaths in newborns with HIE were preceded by EoL decisions mainly within the first 3 days after birth. We did not find changes over the first decade of the 21st century, and death was mainly determined by WDT.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ordens quanto à Conduta (Ética Médica)
/
Hipóxia-Isquemia Encefálica
/
Suspensão de Tratamento
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Newborn
País/Região como assunto:
Europa
Idioma:
En
Revista:
Acta Paediatr
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Espanha