de Kleine M J, de Leeuw R, Kollée L A, Berger H M
Sint Joseph Ziekenhuis, Afd. Neonatologie, Veldhoven.
Ned Tijdschr Geneeskd. 1993 Mar 6;137(10):496-500.
To provide data about continuation or withdrawal of life sustaining therapy in the critical ill newborn.
Retrospective examination of the histories of all 185 patients who died during the year 1990 (17% of total admissions) in 4 out of the 10 neonatal intensive care units in the Netherlands.
The mean gestational age was 31.9 weeks (range 23-43; SD 5.5) and the mean birth weight 1827 g (455-5820; SD 1105). 136 infants were prematurely born, 49 full term. Intensive care was not started in 17 (9%) of the 185 patients and intensive care was withdrawn in 58 patients (31%) because there was no chance of survival. Therapy was withdrawn because of the poor prognosis for the quality of later life in 35 patients (19%). Intensive therapy was continued until death occurred in 74 infants (40%). Respiratory and circulatory problems, infections and severe acquired neurological damage were the main causes of death (32%, 17%, 19% and 24% of the cases respectively). In the cases of death due to respiratory and circulatory failure treatment was continued as long as possible. In infants who died with neurological damage as the main diagnosis, treatment was withdrawn because of the poor prognosis for the quality of life in 25 out of 44 infants.
Life sustaining therapy was withdrawn or not started in 5% of the patients admitted because there was no chance of survival and in 3% because of a poor prognosis for the quality of later life.
提供有关危重新生儿维持生命治疗的继续或停止的数据。
回顾性检查荷兰10个新生儿重症监护病房中4个病房在1990年死亡的所有185例患者（占总入院人数的17%）的病史。
平均胎龄为31.9周（范围23 - 43周；标准差5.5），平均出生体重1827克（455 - 5820克；标准差1105）。136例婴儿为早产，49例为足月产。185例患者中有17例（9%）未开始重症监护，58例患者（31%）因无存活机会而停止了重症监护。35例患者（19%）因后期生活质量预后不良而停止治疗。74例婴儿（40%）继续接受强化治疗直至死亡。呼吸和循环问题、感染以及严重的获得性神经损伤是主要死因（分别占病例的32%、17%、19%和24%）。在因呼吸和循环衰竭死亡的病例中，治疗尽可能持续。在以神经损伤为主要诊断死亡的婴儿中，44例中有25例因生活质量预后不良而停止治疗。
因无存活机会，5%的入院患者未开始或停止了维持生命的治疗；因后期生活质量预后不良，3%的患者停止了治疗。
