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探讨台湾新生儿加护病房中濒死婴儿的状况。

To explore the conditions of dying infants in NICU in Taiwan.

机构信息

Nursing College in Central Taiwan University of Science and Technology, Taiwan.

出版信息

J Crit Care. 2012 Feb;27(1):102.e7-13. doi: 10.1016/j.jcrc.2011.02.045. Epub 2011 May 18.

Abstract

PURPOSES

Research purposes were to document the symptoms characteristic of neonates during their last week of life and to describe the activities undertaken in nursing care of dying neonates in neonatal intensive care unit (NICU).

METHODS

A retrospective chart review was used in this research. All charts of neonatal inpatients who died in the NICU between 2002 and 2008 and who met entry criteria were included the research review.

RESULTS

Sixty-one charts were evaluated in this research. The major underlying disease was the complications of prematurity (33%). Major physiological distress signs in the last week of life included respiratory distress (67.2%), cyanosis (54.1%), bradycardia (36.1%), oliguria (31.1%), and generalized edema (37.7%). All infants were intubated and received artificial ventilation in the last week of life. Physicians prescribed an analgesic medicine for 7 infants, and 7 infants received comfort interventions to manage their distress signs. Forty-one infants had preexisting do-not-resuscitate order at the time of death.

CONCLUSIONS

Research findings suggest that the application of palliative care paradigm and more aggressive comfort care to manage signs in NICU might be beneficial to dying infants.

摘要

目的

研究目的是记录新生儿在生命最后一周的典型症状,并描述新生儿重症监护病房(NICU)中对临终新生儿进行护理的活动。

方法

本研究采用回顾性病历审查。纳入 2002 年至 2008 年期间在 NICU 死亡且符合纳入标准的所有新生儿住院患者的病历进行研究回顾。

结果

本研究共评估了 61 份病历。主要潜在疾病是早产儿并发症(33%)。生命最后一周的主要生理困扰迹象包括呼吸窘迫(67.2%)、发绀(54.1%)、心动过缓(36.1%)、少尿(31.1%)和全身性水肿(37.7%)。所有婴儿在生命的最后一周都接受了气管插管和人工通气。有 7 名医生为 7 名婴儿开了止痛药,有 7 名婴儿接受了舒适干预以缓解他们的不适症状。41 名婴儿在死亡时已经有了预先不进行心肺复苏的医嘱。

结论

研究结果表明,姑息治疗模式的应用和更积极的舒适护理来管理 NICU 中的迹象可能对临终婴儿有益。

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