Weiss A R, Binns H J, Collins J W, deRegnier R-A
Pediatrics, Children's Memorial Hospital, Chicago, IL, USA.
J Perinatol. 2007 Dec;27(12):754-60. doi: 10.1038/sj.jp.7211821. Epub 2007 Aug 30.
To examine influences on neonatologists' decision-making regarding resuscitation of extremely premature infants.
A mailed survey of Illinois neonatologists evaluated influences on resuscitation. Personal and parentally opposed (that is, acting against parental wishes) gray zones of resuscitation were defined, with the lower limit (LL) the gestational age at or below which resuscitation would be consistently withheld and the upper limit (UL) above which resuscitation was mandatory.
Among the 85 respondents, LL and UL of the personal and parentally opposed gray zones were median 22 and 25 weeks, respectively. Neonatologists with an UL personal gray zone <25 completed weeks were significantly more fearful of litigation, more likely to have received didactic/continuing medical education teaching, and less likely to always consider parents' opinions in resuscitation decisions. Neonatologists with an UL parentally opposed gray zone <25 completed weeks were more fearful of litigation.
Neonatologists perceive a 'gray zone' of resuscitative practices and should understand that external influences may affect their delivery room resuscitation practices.
探讨影响新生儿科医生对极早产儿复苏决策的因素。
对伊利诺伊州的新生儿科医生进行邮寄调查，评估复苏的影响因素。定义了个人及违背父母意愿（即违背父母意愿行事）的复苏灰色区域，下限（LL）为孕周，孕周达到或低于该值时将始终不进行复苏，上限（UL）为孕周，高于该值时必须进行复苏。
在85名受访者中，个人及违背父母意愿的灰色区域的下限和上限中位数分别为22周和25周。个人灰色区域上限<25周的新生儿科医生更害怕诉讼，更有可能接受过讲授式/继续医学教育教学，且在复苏决策中不太可能始终考虑父母的意见。违背父母意愿的灰色区域上限<25周的新生儿科医生更害怕诉讼。
新生儿科医生认识到复苏实践存在“灰色区域”，应明白外部影响可能会影响他们在产房的复苏实践。
