Survey shows marked variations in approaches to redirection of care for critically ill very preterm infants in 11 countries




Kjell Helenius, Naho Morisaki, Satoshi Kusuda, Prakesh S. Shah, Mikael Norman, Liisa Lehtonen, Brian Reichman, Brian A. Darlow, Akihiko Noguchi, Mark Adams, Dirk Bassler, Stellan Håkansson, Tetsuya Isayama, Elettra Berti, Shoo K. Lee, Maximo Vento, Kei Lui; on behalf of the International Network for Evaluation of Outcomes of neonates (iNeo)

PublisherWILEY

2019

Acta Paediatrica

ACTA PAEDIATRICA

ACTA PAEDIATR

8

0803-5253

1651-2227

DOIhttps://doi.org/10.1111/apa.15069



Aim

We surveyed care practices for critically ill very preterm infants admitted to neonatal intensive care units (NICUs) in the International Network for Evaluating Outcomes in Neonates (iNeo) to identify differences relevant to outcome comparisons.

Methods

We conducted an online survey on care practices for critically ill very preterm infants and infants with severe intracranial haemorrhage (ICH). The survey was distributed in 2015 to representatives of 390 NICUs in 11 countries. Survey replies were compared with network incidence of death and severe ICH for infants born between 230/7 and 286/7 weeks of gestation from January 1, 2015, to December 31, 2015.

Results

Most units in Israel, Japan and Tuscany, Italy, favoured withholding care when care was considered futile, whereas most units in other networks favoured redirection of care. For infants with bilateral grade 4 ICH, redirection of care was very frequently (≥90% of cases) offered in the majority of units in Australia and New Zealand and Switzerland, but rarely in other networks. Networks where redirection of care was frequently offered for severe ICH had lower rates of survivors with severe ICH.

Conclusion

We identified marked inter‐network differences in care approaches that need to be considered when comparing outcomes.



Last updated on 2024-26-11 at 21:28