Whom are We Comforting? An Analysis of Comfort Medications Delivered to Dying Neonates

Annie Janvier, William Meadow, Steven R. Leuthner, Bree Andrews, Joanne Lagatta, Arend Bos, Laura Lane, A. A. Eduard Verhagen*

*Bijbehorende auteur voor dit werk

OnderzoeksoutputAcademicpeer review

41 Citaten (Scopus)

Samenvatting

Objectives To clarify the use of end-of-life comfort medications or neuromuscular blockers (NMBs) in culturally different neonatal intensive care units (NICUs).

Study design Review of medical files of newborns > 22 weeks gestation who died in the delivery room or the NICU during 12 months in four NICUs (Chicago, Milwaukee, Montreal, and Groningen). We compared use of end-of-life comfort medications and NMBs.

Results None of the babies who died in the delivery room received comfort medications. The use of opiods (77%) or benzodiazepines (41%) around death was similar in all NICUs. Increasing this medication around extubation occurred most often in Montreal, rarely in Milwaukee and Groningen, and never in Chicago. Comfort medications use had no significant impact on the time between extubation and death. NMBs were never used around death in Chicago, once in Montreal, and more frequently in Milwaukee and Groningen. Initiation of NMB after extubation occurred only in Groningen.

Conclusion Comfort medications were administered to almost all dying infants in each NICU. Some, but not all, centers were comfortable increasing these medications around or after extubation. In three centers, NMBs were at times present at the time of death. However, only in Holland were NMBs initiated after extubation. (J Pediatr 2011; 159: 206-10).

Originele taal-2English
Pagina's (van-tot)206-210
Aantal pagina's5
TijdschriftJournal of Pediatrics
Volume159
Nummer van het tijdschrift2
DOI's
StatusPublished - aug-2011

Citeer dit