title: When should resuscitation at birth cease?
abstract: It is rare for newborn infants to require prolonged resuscitation at birth. While there are detailed national and international guidelines on when and how to provide resuscitation to newborns, there is little existing guidance on when newborn resuscitation should be stopped. In this paper we review current guidance surrounding adult, paediatric and neonatal resuscitation as well as recent evidence of outcome for newborn infants requiring prolonged resuscitation. We discuss the ethical principles that can potentially guide decisions surrounding resuscitation and post-resuscitation care. We also propose a structured approach to stopping resuscitation.
authors.affiliation: John Radcliffe Hospital, Oxford, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: McGrath
authors.affiliation: John Radcliffe Hospital, Oxford, UK; Dept. Neonatology, Charité University Medical Center Berlin, Germany.
authors.forename: C C
authors.initials: CC
authors.lastname: Roehr
authors.affiliation: John Radcliffe Hospital, Oxford, UK; Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, UK. Electronic address: dominic.wilkinson@philosophy.ox.ac.uk.
authors.forename: D J C
authors.initials: DJ
authors.lastname: Wilkinson
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000941:ethics / Q000592:standards*; D002986:Clinical Trials as Topic; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000941:ethics / Q000379:methods / Q000592:standards*; D017410:Practice Guidelines as Topic; D016414:Resuscitation Orders
keywords: Apgar score; Hypoxia-ischemia, brain; Infant, newborn; Medical ethics; Resuscitation