新生儿护理中无效治疗的临床概念及伦理合理限度：一例1分钟、5分钟和10分钟阿氏评分均为0分婴儿的病例报告

Clinical concepts of futility and ethically justified limits on neonatal care: a case presentation of an infant with Apgar scores of 0 at 1, 5, and 10 minutes.

作者信息

McGraw Melanie P, Perlman Jeffrey, Chervenak Frank A, McCullough Laurence B

机构信息

Division of Newborn Medicine, New York Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, New York, NY 10021, USA.

出版信息

Am J Perinatol. 2006 Apr;23(3):159-62. doi: 10.1055/s-2006-934095. Epub 2006 Mar 29.

DOI:10.1055/s-2006-934095

PMID:16586231

Abstract

Appropriate length of delivery room resuscitative efforts for infants born without signs of life is controversial. We present the case of a preterm infant with Apgar scores of 0 at 1, 5, and 10 minutes but with a recovered heartbeat at 15 minutes. Using the clinically relevant conceptions of the principle of futility, we examine the ethical justification for the successive decisions to initiate, continue, and ultimately limit care for this patient. This difficult case highlights the importance of understanding the ethical justification for clinical interventions that are made in the neonatal intensive care unit.

摘要

对于出生时无生命迹象的婴儿，产房复苏努力的适宜时长存在争议。我们报告一例早产婴儿病例，其1分钟、5分钟和10分钟时的阿氏评分均为0，但在15分钟时心跳恢复。我们运用临床上关于无效原则的相关概念，审视了针对该患者启动、继续并最终限制治疗的一系列决策的伦理依据。这一棘手病例凸显了理解新生儿重症监护病房临床干预伦理依据的重要性。