Experience with newborn intensive care deaths in a tertiary setting.
The purpose of this paper is to report the longitudinal experience with deaths in a United States' newborn intensive care unit. Retrospective analysis comparing infant deaths in two epochs: Epoch 1: 1985-1988 (n = 127) and Epoch 2: 1991-1994 (n = 75). Data included demographic factors, age at death, episodes of cardiopulmonary resuscitation, do not resuscitate status, and whether withdrawal of support occurred. Infants in Epoch 2 were significantly younger at birth (28.7 +/- 0.7 vs. 30.6 +/- 0.5 wks', p = 0.02) and death (31.5 +/- 0.9 vs. 34.0 +/- 0.7 wks', p = 0.02) than those in Epoch 1. There was no difference in length of stay (19.5 +/- 5.1 vs. 24.4 +/- 4.2 days, Epoch 2 vs. Epoch 1). Infants were more likely to receive cardiopulmonary resuscitation in Epoch 2 than Epoch 1 (60 vs. 41%, p = 0.008). However, more infants in Epoch 2 also had do not resuscitate status (80% vs. 59%, p = 0.002) or withdrawal of support (72% vs. 52%, p = 0.005). The majority of newborn intensive care deaths currently occur with do not resuscitate status and/or withdrawal of support.
McHugh-Strong
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CM
Department of Psychiatry, The Veterans Administration Health Care System, New Haven, Connecticut, USA.
Sanders
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MR
D016887:Cardiopulmonary Resuscitation; D002423:Cause of Death; D003237:Connecticut / Q000453:epidemiology; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D016414:Resuscitation Orders; D012189:Retrospective Studies