Objective

Describe care surrounding the end of life (EOL) in the neonatal intensive care unit (NICU).

Study design

Retrospective chart review of 208 infants who died in a level IV referral-only NICU over 5 years.

Results

A goals of care (GOC) conversation was documented before the day of death for 63% of infants. 73% died following withdrawal of life-sustaining treatment (WD); 13% died in a code. The median age at death was 17.5 days. 72% were held by a parent at EOL. 94% of families desired formal memory-making. We identified associations with mode of death and parental holding at death, including: WD was associated with palliative care consultation, early GOC conversations, and increased unit-specific length of stay. Holding was associated with chaplain visits, memory-making, and increased home-to-hospital distance.

Conclusion

We present a detailed description of EOL care in an outborn NICU, including novel data on parental holding and memory-making.

中文翻译：

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IV 级出生新生儿重症监护病房的临终关怀

客观的

描述新生儿重症监护病房 (NICU) 中有关临终 (EOL) 的护理。

学习规划

对 5 年来在 IV 级转诊 NICU 中死亡的 208 名婴儿进行回顾性图表审查。

结果

63% 的婴儿在死亡当天之前记录了护理目标 (GOC) 对话。73% 的人在停止维持生命治疗 (WD) 后死亡；13% 死于代码。死亡中位年龄为 17.5 天。72% 由 EOL 的母公司持有。94% 的家庭希望进行正式的记忆制作。我们确定了死亡方式和父母在死亡时的监护方式之间的关联，包括： WD 与姑息治疗咨询、早期 GOC 对话以及特定科室住院时间的增加相关。拘留与牧师探访、记忆形成以及家与医院距离的增加有关。

结论

我们详细描述了新生儿重症监护病房中的 EOL 护理，包括有关父母持有和记忆形成的新数据。