Impact of the perception of viability on resource allocation in the neonatal intensive care unit.
OBJECTIVE
To understand how neonatologists' perceptions of viability impact their willingness to recommend or provide medical interventions for infants born at 23 to 24 weeks' gestation.


METHODS
A 25-question survey mailed to 3056 neonatologists in the United States in 1992 yielded 1131 responses. Seven hundred seventy-five (775 of 1131, 69%) reported they believed that the lower limit of viability was 23 to 24 weeks' gestation. These respondents were asked if they were willing to recommend or provide a series of medical interventions for infants born at 23 and 24 weeks' gestation.


RESULTS
Most respondents would provide ventilation (82% and 95%) and surfactant (62% and 78%) for infants born at 23 and 24 weeks' gestation, respectively. The respondent's prediction of <100% mortality, infant factors, and parental wishes were significant predictors of willingness to resuscitate infants born at 23 weeks' gestation.


CONCLUSIONS
There is considerable variation among neonatologists in their willingness to recommend or provide medical interventions for infants born at 23 to 24 weeks' gestation.
Department of Pediatrics, University of Connecticut School of Medicine, Farmington, USA.
M R
MR
Sanders
P K
PK
Donohue
M A
MA
Oberdorf
T S
TS
Rosenkrantz
M C
MC
Allen
D001291:Attitude of Health Personnel; D005865:Gestational Age; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data*; D010465:Perception; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D014481:United States