EXPERIENCE WITH NEWBORN INTENSIVE CARE DEATHS IN A TERTIARY SETTING

ABSTRACT

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.

KEYWORD

Bioethics - newborn - death - do not resuscitate