Bjerager M O, Steensberg J, Greisen G
Rigshospitalet, Juliane Marie Centret, neonaltalklinikken.
Ugeskr Laeger. 1999 Mar 29;161(13):1916-9.
The circumstances of 88 deaths in the Neonatal Department, Rigshospitalet Copenhagen, were reviewed with special emphasis on the clinical background for, and parental attitude to withholding life-sustaining treatment. We recorded whether these considerations appeared in the patient's medical record, the type of treatment withheld and the use of opioids. No infant died under ongoing maximal treatment. Fourteen infants were judged to have died with "almost certainty" (gr A), 48 infants were judged to have died with great probability (gr B) and 26 infants were judged to have had a considerable chance of survival (gr C). Opioids were used more often in the terminal course of treatment in group C as opposed to group B. Parental attitudes and clinical background were not fully described in the medical record for many patients. The decision to withhold life sustaining treatment in the severely ill neonate was made to avoid prolonged futile suffering, or survival with very severe handicaps.
我们回顾了哥本哈根大学 Rigshospitalet 医院新生儿科 88 例死亡病例的情况，特别关注了停止维持生命治疗的临床背景以及家长的态度。我们记录了这些考量因素是否出现在患者的病历中、所停止的治疗类型以及阿片类药物的使用情况。没有婴儿在进行最大程度治疗时死亡。14 例婴儿被判定“几乎肯定”死亡（A 组），48 例婴儿被判定极有可能死亡（B 组），26 例婴儿被判定有相当大的存活机会（C 组）。与 B 组相比，C 组在治疗末期更常使用阿片类药物。许多患者的病历中没有充分描述家长的态度和临床背景。对重症新生儿停止维持生命治疗的决定是为了避免长期的徒劳痛苦或伴有严重残疾的存活。
