Changes in the Delivery Room Care of the Extremely Small Infant (Under 750g)
Fanaroff, Avroy A.
New England Journal of Medicine. 1986 Mar 6; 314(10): 660-664.
Patterns and outcomes of care were analyzed for 98 infants with birth weights below 750 grams who were born between 1 July 1982 and 30 June 1985 at the University Hospitals of Cleveland. Endotracheal intubation and respiratory support were applied to smaller and less mature infants during the three-year period. Twenty of 42 infants admitted to the neonatal intensive care unit (NICU) survived compared with none of the 56 who did not receive NICU care. The authors conclude that the survival of infants less than 750 grams necessitates early aggressive management, but that the ongoing medical, financial, and social costs must be considered when divising definitive guidelines. They also suggest that the poor previous reproductive history and high risk pregnancy status of a majority of the mothers indicate a need for preventing or treating the causes of immature births rather than expending resources on prolonged neonatal intensive care. (KIE abstract)
Biomedical Technologies; Costs and Benefits; Evaluation; Extraordinary Treatment; Guidelines; Hospitals; Infants; Institutional Policies; Intensive Care Units; Minors; Morbidity; Mortality; Mothers; Newborns; Patient Care; Prematurity; Prognosis; Pregnancy; Resource Allocation; Resuscitation; Resuscitation Orders; Risk; Selection for Treatment; Statistics;
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