Characterization of Death in Neonatal Encephalopathy in the Hypothermia Era.

Journal Article

This study aimed to characterize the circumstances of death in encephalopathic neonates treated with therapeutic hypothermia. Patients who died after or during treatment with therapeutic hypothermia between 2007-2014 were identified. Patient circumstance of death was characterized using an established paradigm. Thirty-one of 229 patients died (14%) at a median of 3 days of life. Most who died were severely encephalopathic on examination (90%) and had severely abnormal electroencephalographic (EEG) findings (87%). All those who had magnetic resonance images (n = 13) had evidence of moderate-severe brain injury; 6 had near-total brain injury. Cooling was discontinued prematurely in 61% of patients. Most patients (90%) were physiologically stable at the time of death; 81% died following elective extubation for quality of life considerations. Three patients (10%) died following withholding or removal of artificial hydration and nutrition. Characterization of death in additional cohorts is needed to identify differences in decision making practices over time and between centers.

Full Text

Duke Authors

Cited Authors

  • Lemmon, ME; Boss, RD; Bonifacio, SL; Foster-Barber, A; Barkovich, AJ; Glass, HC

Published Date

  • March 2017

Published In

Volume / Issue

  • 32 / 4

Start / End Page

  • 360 - 365

PubMed ID

  • 28193115

Electronic International Standard Serial Number (EISSN)

  • 1708-8283

International Standard Serial Number (ISSN)

  • 0883-0738

Digital Object Identifier (DOI)

  • 10.1177/0883073816681904

Language

  • eng