McLaughlin S Nicole, Song Mi-Kyung, Hertzberg Vicki, Piazza Anthony J
Emory University, Atlanta, Georgia (Drs McLaughlin, Song, and Piazza); Center for Nursing Excellence in Palliative Care (Dr Song) and Center for Data Science (Dr Hertzberg), Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia; and Children's Healthcare of Atlanta at Egleston, Georgia (Dr Piazza).
Adv Neonatal Care. 2020 Apr;20(2):136-141. doi: 10.1097/ANC.0000000000000698.
Palliative care is becoming an important component for infants with life-limiting or life-threatening conditions and their families. Yet palliative care practices appear to be inconsistent and sporadically used for infants.
The purpose of this study was to describe the use of an established pediatric palliative care team for seriously ill infants in a metropolitan hospital.
This was a retrospective medical record review.
The population included 64 infants who were admitted to a level IV neonatal intensive care unit (NICU) and then died during hospitalization between January 2015 and December 2016. Most infants died in an ICU (n = 63, 95%), and only 20 infants (31%) received palliative care consultation. Most common reasons for consultation were care coordination, defining goals of care and end-of-life planning, and symptom management.
Palliative care consultation at this institution did not change the course of end-of-life care. Interventions provided by the ICU team to infants surrounding end of life were similar to those in infants receiving palliative care services from the specialists. Our findings may be useful for developing guidelines regarding how to best utilize palliative care services for infants with life-threatening conditions who are admitted to an ICU.
These finding support continued research in neonatal palliative care, more specifically the impact of palliative care guidelines and algorithms.
姑息治疗正成为患有危及生命或生命受限疾病的婴儿及其家庭的重要组成部分。然而，姑息治疗实践似乎并不一致，且在婴儿中使用较为零散。
本研究的目的是描述一家大都市医院中一个成熟的儿科姑息治疗团队对重症婴儿的使用情况。
这是一项回顾性病历审查。
研究对象包括64名入住四级新生儿重症监护病房（NICU）并于2015年1月至2016年12月住院期间死亡的婴儿。大多数婴儿在重症监护病房死亡（n = 63，95%），只有20名婴儿（31%）接受了姑息治疗咨询。咨询的最常见原因是护理协调、确定护理目标和临终规划以及症状管理。
该机构的姑息治疗咨询并未改变临终护理的进程。重症监护病房团队在婴儿临终时提供的干预措施与接受专科医生姑息治疗服务的婴儿相似。我们的研究结果可能有助于制定有关如何最佳利用姑息治疗服务为入住重症监护病房的患有危及生命疾病的婴儿提供服务的指南。
这些发现支持继续开展新生儿姑息治疗研究，更具体地说，是姑息治疗指南和算法的影响研究。
