Categorizing Neonatal Deaths:A Cross-Cultural Study in the United States, Canada, and The Netherlands

Objective To clarify the process of end-of-life decision-making in culturally different neonatal intensive care units (NICUs). Study design Review of medical files of newborns >22 weeks gestation who died in the delivery room (DR) or the NICU during 12 months in 4 NICUs (Chicago, Milwaukee, Montreal, and Groningen). We categorized deaths using a 2-by-2 matrix and determined whether mechanical ventilation was withdrawn/withheld and whether the child was dying despite ventilation or physiologically stable but extubated for neurological prognosis. Results Most unstable patients in all units di... Mehr ...