End-of-life care over four decades in a quaternary neonatal intensive care unit

Abstract

Aim: Death in the neonatal intensive care unit (NICU) commonly follows a decision to withdraw or limit life-sustaining treatment. Advances in medicine have changed the nature of life-sustaining interventions available and the potential prognosis for many newborn conditions. We aimed to assess changes in causes of death and end-of-life care over nearly four decades. Methods: A retrospective review of infants dying in the NICU was performed (2017–2020) and compared with previous audits performed in the same centre (1985–1987 and 1999–2001). Diagnoses at death were recorded for each infant as well as their apparent prognosis and any withdrawal or limitations of medical treatment. Results: In th..