Use of Palliative Care Consultation Services for Infants With Life-Threatening Conditions in a Metropolitan Hospital.

BACKGROUND

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.

PURPOSE

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.

METHODS

This was a retrospective medical record review.

FINDINGS

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.

IMPLICATIONS FOR PRACTICE

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.

IMPLICATIONS FOR RESEARCH

These finding support continued research in neonatal palliative care, more specifically the impact of palliative care guidelines and algorithms.