Survey shows marked variations in approaches to redirection of care for critically ill very preterm infants in 11 countries.
international survey
neonatal intensive care
redirection of care
severe intracranial haemorrhage
very preterm infant
Journal
Acta paediatrica (Oslo, Norway : 1992)
ISSN: 1651-2227
Titre abrégé: Acta Paediatr
Pays: Norway
ID NLM: 9205968
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
21
05
2019
revised:
03
10
2019
accepted:
18
10
2019
pubmed:
21
10
2019
medline:
15
5
2021
entrez:
21
10
2019
Statut:
ppublish
Résumé
We surveyed care practices for critically ill very preterm infants admitted to neonatal intensive care units (NICUs) in the International Network for Evaluating Outcomes in Neonates (iNeo) to identify differences relevant to outcome comparisons. We conducted an online survey on care practices for critically ill very preterm infants and infants with severe intracranial haemorrhage (ICH). The survey was distributed in 2015 to representatives of 390 NICUs in 11 countries. Survey replies were compared with network incidence of death and severe ICH for infants born between 23 Most units in Israel, Japan and Tuscany, Italy, favoured withholding care when care was considered futile, whereas most units in other networks favoured redirection of care. For infants with bilateral grade 4 ICH, redirection of care was very frequently (≥90% of cases) offered in the majority of units in Australia and New Zealand and Switzerland, but rarely in other networks. Networks where redirection of care was frequently offered for severe ICH had lower rates of survivors with severe ICH. We identified marked inter-network differences in care approaches that need to be considered when comparing outcomes.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1338-1345Subventions
Organisme : CIHR
ID : APR-126340
Pays : Canada
Organisme : CIHR
ID : CTP 87518
Pays : Canada
Informations de copyright
© 2019 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Références
Stoll BJ, Hansen NI, Bell EF, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993-2012. JAMA. 2015;314:1039-1051.
Mukerji A, Shah V, Shah PS, et al. Periventricular/intraventricular hemorrhage and neurodevelopmental outcomes: a meta-analysis. Pediatrics. 2015;136:1132-1143.
Lam HS, Wong SPS, Liu FYB, Wong HL, Fok TF, Ng PC. Attitudes toward neonatal intensive care treatment of preterm infants with a high risk of developing long-term disabilities. Pediatrics. 2009;123:1501-1508.
Hendriks MJ, Klein SD, Bucher HU, Baumann-Hölzle R, Streuli JC, Fauchère J-C. Attitudes towards decisions about extremely premature infants differed between Swiss linguistic regions in population-based study. Acta Paediatr. 2017;106:423-429.
Lantos JD. Ethical problems in decision making in the neonatal ICU. Longo DL, editor. N Engl J Med. 2018;379:1851-1860.
Rysavy MA, Li L, Bell EF, et al. Between-hospital variation in treatment and outcomes in extremely preterm infants. N Engl J Med. 2015;372:1801-1811.
Helenius K, Sjörs G, Shah PS, et al. Survival in very preterm infants: an international comparison of 10 national neonatal networks. Pediatrics. 2017;140:e20171264.
Shah PS, Lui K, Sjörs G, et al. Neonatal outcomes of very low birth weight and very preterm neonates: an international comparison. J Pediatr. 2016;177:144-152.
Shah PS, Lee SK, Lui K, et al. The international network for evaluating outcomes of very low birth weight, very preterm neonates (iNeo): a protocol for collaborative comparisons of international health services for quality improvement in neonatal care. BMC Pediatr. 2014;14:110.
Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978;92:529-534.
Berger TM, Hofer A. Causes and circumstances of neonatal deaths in 108 consecutive cases over a 10-year period at the Children’s Hospital of Lucerne, Switzerland. Neonatology. 2009;95:157-163.
Wilkinson DJ, Fitzsimons JJ, Dargaville PA, et al. Death in the neonatal intensive care unit: changing patterns of end of life care over two decades. Arch Dis Child Fetal Neonatal Ed. 2006;91:268-271.
Eventov-Friedman S, Kanevsky H, Bar-Oz B. Neonatal end-of-life care: a single-center NICU experience in Israel over a decade. Pediatrics. 2013;131:e1889-e1896.
Grupo de Trabajo de la Sociedad Española de Neonatología sobre Limitación del Esfuerzo Terapéutico y Cuidados Paliativos en recién nacidos. Decisions on limiting treatment in critically-ill neonates: a multicenter study. An Esp Pediatr. 2002;57:547-553.
Hellmann J, Knighton R, Lee SK, et al. Neonatal deaths: prospective exploration of the causes and process of end-of-life decisions. Arch Dis Child Fetal Neonatal Ed. 2016;101:F102-F107.
Schindler T, Koller-Smith L, Lui K, Bajuk B, Bolisetty S. Causes of death in very preterm infants cared for in neonatal intensive care units: a population-based retrospective cohort study. BMC Pediatr. 2017;17:1-9.
Janvier A, Leblanc I, Barrington KJ. The best-interest standard is not applied for neonatal resuscitation decisions. Pediatrics. 2008;121:963-969.
Hagen EM, Therkelsen ØB, Førde R, Aasland O, Janvier A, Hansen TW. Challenges in reconciling best interest and parental exercise of autonomy in pediatric life-or-death situations. J Pediatr. 2012;161:146-151.
Rebagliato M, Cuttini M, Broggin L, et al. Neonatal end-of-life decision making. JAMA. 2000;284:2451-2459.
Schneider K, Metze B, Bührer C, Cuttini M, Garten L. End-of-life decisions 20 years after EURONIC: neonatologists’ self-reported practices, attitudes, and treatment choices in Germany, Switzerland, and Austria. J Pediatr. 2019;207:154-160.
Cuttini M, Nadai M, Kaminski M, et al. End-of-life decisions in neonatal intensive care: physicians’ self-reported practices in seven European countries. EURONIC study group. Lancet. 2000;355:2112-2118.
Gallagher K, Aladangady N, Marlow N. The attitudes of neonatologists towards extremely preterm infants: a Q methodological study. Arch Dis Child Fetal Neonatal Ed. 2016;101:31-36.