Delivery room resuscitation decisions for extremely low birthweight infants in California

被引：0

作者：

Partridge J.C. ^{[1
,6
]}

Freeman H. ^{[2
,4
]}

Weiss E. ^{[3
,5
]}

Martinez A.M. ^{[1
]}

机构：

[1] Univ. of California, San Francisco, San Francisco General Hospital, San Francisco, CA

[2] School of Medicine, Temple University, Philadelphia, PA

[3] School of Medicine, SUNY Stony Brook School of Medicine, Stony Brook, NY

[4] Department of Radiology, Mt. Sinai Medical Center, New York, NY

[5] Dept. Obstet., Gynecol., Repro. Sci., Univ. of California, San Francisco, San Francisco, CA

[6] Department of Pediatrics, Univ. of California, San Francisco, San Francisco General Hospital, San Francisco, CA 94110

来源：

Journal of Perinatology | 2001年 / 21卷 / 1期

关键词：

D O I：

10.1038/sj.jp.7200477

中图分类号：

学科分类号：

摘要：

OBJECTIVE: To characterize physician-parent counseling and delivery room resuscitation of extremely low birthweight (ELBW) infants. STUDY DESIGN: Cross-sectional survey of 473 California neonatologists detailing counseling patterns, resuscitation thresholds, and acceptance of parental decision making. RESULTS: The response rate was 61%. After 23 weeks' gestation, >80% of neonatologists counseled parents expecting ELBW infants. All (>99%) counseled parents about mortality; >25% reported not discussing limiting resuscitation or death despite resuscitation. Decisions to limit resuscitation were affected by congenital anomalies, parents' wishes, or perceptions of pain, suffering, and quality of life. Nearly 70% of neonatologists supported parental decision making at 22 to 23 weeks, whereas 66% to 74% responded that parents should not be allowed to make nonresuscitation decisions after 26 weeks. Median resuscitation thresholds were 23 weeks (range 20-28) and 500 g (range350-1000). CONCLUSIONS: Neonatologists' failure to discuss nonresuscitation options, variations in resuscitation thresholds, and unwillingness to accept nonresuscitation decisions for more mature ELBW infants may restrict parental decision making.

引用

页码：27 / 33

页数：6

共 43 条

[1]

Lee S., Penner P., Cox M., Comparison of the attitudes of health care professionals and parents toward active treatment of very low birth wight infants, Pediatrics, 88, pp. 110-114, (1991)

[2]

Davis D.J., How aggressive should delivery room cardiopulmonary resuscitation be for extremely low birth weight neonates, Pediatrics, 92, pp. 447-450, (1993)

[3]

Pinkerton J.V., Finnerty J.J., Lombardo P.A., Rorty M.V., Chapple H., Boyle R.J., Parental rights at the birth of a near-viable infant: Conflicting perspectives, Am J Obstet Gynecol, 177, pp. 283-290, (1997)

[4]

Silverman W., Overtreatment of neonates? A personal retrospective, Pediatrics, 90, pp. 971-976, (1992)

[5]

Allen M., Donohue P., Dusman A., The limit of viability - Neonatal outcome of infants born at 22 to 25 weeks' gestation, N Engl J Med, 329, pp. 1597-1601, (1993)

[6]

The Vermont-Oxford Trials Network: Very low birth weight outcomes for 1990, Pediatrics, 91, pp. 540-545, (1993)

[7]

Neonatal Intensive Care for Low Birthweight Infants: Costs and Effectiveness, (1987)

[8]

Kilpatrick S., Schlueter M., Piecuch R., Leonard C., Rogido M., Sola A., Outcome of infants born at 24-26 weeks' gestation: I. Survival and cost, Obstet Gynecol, 90, pp. 803-808, (1997)

[9]

Piecuch R.E., Leonard C.H., Cooper B.A., Kilpatrick S.J., Schlueter M.A., Sola A., Outcome of infants born at 24-26 weeks' gestation: II. Neurodevelopmental outcome, Obstet Gynecol, 90, pp. 809-814, (1997)

[10]

Benfield D., Leib S., Vollman J., Grief responses of parents to neonatal death and parent participation in deciding care, Pediatrics, 62, pp. 171-177, (1978)

← 1 2 3 4 5 →