Resuscitation at the limits of viability--an Irish perspective.

Hdl Handle:
http://hdl.handle.net/10147/207992
Title:
Resuscitation at the limits of viability--an Irish perspective.
Authors:
Khan, R A; Burgoyne, L; O'Connell, M P; Dempsey, E M
Affiliation:
Paediatrics and Newborn Medicine, Coombe Women and Infant University Hospital,, Dublin, Ireland.
Citation:
Acta Paediatr. 2009 Sep;98(9):1456-60.
Journal:
Acta paediatrica (Oslo, Norway : 1992)
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207992
DOI:
10.1111/j.1651-2227.2009.01400.x
PubMed ID:
19673731
Abstract:
BACKGROUND: Advances in neonatal care continue to lower the limit of viability. Decision making in this grey zone remains a challenging process. OBJECTIVE: To explore the opinions of healthcare providers on resuscitation and outcome in the less than 28-week preterm newborn. DESIGN/METHODS: An anonymous postal questionnaire was sent to health care providers working in maternity units in the Republic of Ireland. Questions related to neonatal management of the extreme preterm infant, and estimated survival and long-term outcome. RESULTS: The response rate was 55% (74% obstetricians and 70% neonatologists). Less than 1% would advocate resuscitation at 22 weeks, 10% of health care providers advocate resuscitation at 23 weeks gestation, 80% of all health care providers would resuscitate at 24 weeks gestation. 20% of all health care providers would advocate cessation of resuscitation efforts on 22-25 weeks gestation at 5 min of age. 65% of Neonatologists and 54% trainees in Paediatrics would cease resuscitation at 10 min of age. Obstetricians were more pessimistic about survival and long term outcome in newborns delivered between 23 and 27 weeks when compared with neonatologists. This difference was also observed in trainees in paediatrics and obstetrics. CONCLUSION: Neonatologists, trainees in paediatrics and neonatal nurses are generally more optimistic about outcome than their counterparts in obstetrical care and this is reflected in a greater willingness to provide resuscitation efforts at the limits of viability.
Language:
eng
MeSH:
Age Factors; *Attitude of Health Personnel; Fetal Viability; *Gestational Age; Health Personnel/psychology/*statistics & numerical data; Humans; Infant Mortality; Infant, Newborn; *Infant, Premature; Intensive Care, Neonatal; Ireland; Questionnaires; *Resuscitation; Survival Analysis; Time Factors; Treatment Outcome; Withholding Treatment
ISSN:
1651-2227 (Electronic); 0803-5253 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKhan, R Aen_GB
dc.contributor.authorBurgoyne, Len_GB
dc.contributor.authorO'Connell, M Pen_GB
dc.contributor.authorDempsey, E Men_GB
dc.date.accessioned2012-02-01T10:57:01Z-
dc.date.available2012-02-01T10:57:01Z-
dc.date.issued2012-02-01T10:57:01Z-
dc.identifier.citationActa Paediatr. 2009 Sep;98(9):1456-60.en_GB
dc.identifier.issn1651-2227 (Electronic)en_GB
dc.identifier.issn0803-5253 (Linking)en_GB
dc.identifier.pmid19673731en_GB
dc.identifier.doi10.1111/j.1651-2227.2009.01400.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/207992-
dc.description.abstractBACKGROUND: Advances in neonatal care continue to lower the limit of viability. Decision making in this grey zone remains a challenging process. OBJECTIVE: To explore the opinions of healthcare providers on resuscitation and outcome in the less than 28-week preterm newborn. DESIGN/METHODS: An anonymous postal questionnaire was sent to health care providers working in maternity units in the Republic of Ireland. Questions related to neonatal management of the extreme preterm infant, and estimated survival and long-term outcome. RESULTS: The response rate was 55% (74% obstetricians and 70% neonatologists). Less than 1% would advocate resuscitation at 22 weeks, 10% of health care providers advocate resuscitation at 23 weeks gestation, 80% of all health care providers would resuscitate at 24 weeks gestation. 20% of all health care providers would advocate cessation of resuscitation efforts on 22-25 weeks gestation at 5 min of age. 65% of Neonatologists and 54% trainees in Paediatrics would cease resuscitation at 10 min of age. Obstetricians were more pessimistic about survival and long term outcome in newborns delivered between 23 and 27 weeks when compared with neonatologists. This difference was also observed in trainees in paediatrics and obstetrics. CONCLUSION: Neonatologists, trainees in paediatrics and neonatal nurses are generally more optimistic about outcome than their counterparts in obstetrical care and this is reflected in a greater willingness to provide resuscitation efforts at the limits of viability.en_GB
dc.language.isoengen_GB
dc.subject.meshAge Factorsen_GB
dc.subject.mesh*Attitude of Health Personnelen_GB
dc.subject.meshFetal Viabilityen_GB
dc.subject.mesh*Gestational Ageen_GB
dc.subject.meshHealth Personnel/psychology/*statistics & numerical dataen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInfant Mortalityen_GB
dc.subject.meshInfant, Newbornen_GB
dc.subject.mesh*Infant, Prematureen_GB
dc.subject.meshIntensive Care, Neonatalen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshQuestionnairesen_GB
dc.subject.mesh*Resuscitationen_GB
dc.subject.meshSurvival Analysisen_GB
dc.subject.meshTime Factorsen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.subject.meshWithholding Treatmenten_GB
dc.titleResuscitation at the limits of viability--an Irish perspective.en_GB
dc.contributor.departmentPaediatrics and Newborn Medicine, Coombe Women and Infant University Hospital,, Dublin, Ireland.en_GB
dc.identifier.journalActa paediatrica (Oslo, Norway : 1992)en_GB
dc.description.provinceLeinster-
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.