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Seminars in Fetal & Neonatal Medicine最新文献

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Palliative care for NICU survivors with chronic critical illness NICU慢性危重疾病幸存者的姑息治疗
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101446
Renee D. Boss
{"title":"Palliative care for NICU survivors with chronic critical illness","authors":"Renee D. Boss","doi":"10.1016/j.siny.2023.101446","DOIUrl":"10.1016/j.siny.2023.101446","url":null,"abstract":"<div><p><span><span>The sickest of NICU<span> survivors develop chronic critical illness (CCI). Most infants with CCI will leave the NICU using chronic </span></span>medical technology and will experience repeated rehospitalizations. The unique issues for these NICU graduates— escalating chronic medical technologies, fractured post-NICU healthcare, gaps in home health services, and family strain—are common and predictable. This means that raising family and NICU team awareness of these issues, and putting plans in place to address them, should occur for every NICU infant with CCI. </span>Pediatric palliative care<span> is one resource that can be engaged within the NICU to support the child and family through NICU discharge and beyond. This review examines what is known about the unique needs of infants who leave the NICU with CCI and the role that NICU-initiated palliative care<span> involvement can play for these patients, families, clinicians, and the health care system.</span></span></p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101446"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spiritual and cultural influences on end-of-life care and decision-making in NICU 精神和文化对新生儿重症监护室临终关怀和决策的影响。
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101437
Pak C. Ng, Genevieve P.G. Fung
{"title":"Spiritual and cultural influences on end-of-life care and decision-making in NICU","authors":"Pak C. Ng,&nbsp;Genevieve P.G. Fung","doi":"10.1016/j.siny.2023.101437","DOIUrl":"10.1016/j.siny.2023.101437","url":null,"abstract":"<div><p>Understanding and respecting the spiritual beliefs, ethnic roots, cultural norms and customs of individual families is essential for neonatologists to provide clinically appropriate and humane end-of-life care. This review describes the religious/philosophical principles, cultural-related practices/rituals, and traditions in end-of-life care in major spiritual groups of today's multi-cultural, multi-faith societies. The spiritual groups include Christians, Muslims, Jewish Judaism believers and Asian religious/philosophy followers such as Buddhists, Hindus, Taoists, Confucianism devotees and ancestral worshippers. It is vital to understand that substantial variation in views and practices may exist even within the same religion and culture in different geographic locations. Ethical views and cultural practices are not static elements in life but behave in a fluidic and dynamic manner that could change with time. Interestingly, an evolving pattern has been observed in some Asian and Middle East countries that more parents and/or religious groups are beginning to accept a form of redirection of care most compatible with their spiritual belief and culture. Thus, every family must be assessed and counseled individually for end-of-life decision-making. Also, every effort should be made to comply with parents' requests and to treat infants/parents of different religions and cultures with utmost dignity so that they have no regret for their irreversible decisions.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101437"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10136808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Unmasking grief: Reflections on the complicated relationship between moral distress and grief 揭露悲伤：对道德痛苦和悲伤之间复杂关系的思考。
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101445
Lucia D. Wocial , Ann Hannan
{"title":"Unmasking grief: Reflections on the complicated relationship between moral distress and grief","authors":"Lucia D. Wocial ,&nbsp;Ann Hannan","doi":"10.1016/j.siny.2023.101445","DOIUrl":"10.1016/j.siny.2023.101445","url":null,"abstract":"<div><p><span>Perinatal loss often occurs in the context of discovery of a medical condition that presents patients and healthcare providers (HCPs) with difficult choices. Treatment choices are influenced by </span>medical technology, however inescapable prognostic uncertainty, coupled with shared decision-making can lead to ethical dilemmas (Graf et al., 2023) [1]. When patients experience perinatal loss HCPs must grapple with their own emotions. Their sense of grief arises from their empathic connection with patients, bearing witness to their grief. This grief may compound HCP moral distress. Moral distress has an element of emotion, however it is more than distress in tragic situations. Moral distress is linked to HCPs feeling responsible to take action (Dudzinski, 2016) [2]. In situations of perinatal loss, it is essential to acknowledge the grief and explore how it influences the experience of moral distress. This article will reflect on the impact of HCP grief in ethically complex situation of perinatal loss.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101445"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
End of life care in the setting of extreme prematurity – practical challenges and ethical controversies 极端早产环境下的临终关怀——实践挑战与伦理争议
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101442
Dominic JC. Wilkinson , Sophie Bertaud
{"title":"End of life care in the setting of extreme prematurity – practical challenges and ethical controversies","authors":"Dominic JC. Wilkinson ,&nbsp;Sophie Bertaud","doi":"10.1016/j.siny.2023.101442","DOIUrl":"10.1016/j.siny.2023.101442","url":null,"abstract":"<div><p>While the underlying principles are the same, there are differences in practice in end of life decisions and care for extremely preterm infants compared with other newborns and older children. In this paper, we review end of life care for extremely preterm infants in the delivery room and in the neonatal intensive care unit. We identify potential justifications for differences in the end of life care in this population as well as practical and ethical challenges.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101442"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10518855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Operationalizing neonatal palliative care 实施新生儿姑息治疗
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101474
Renee D. Boss, Mark R. Mercurio
{"title":"Operationalizing neonatal palliative care","authors":"Renee D. Boss,&nbsp;Mark R. Mercurio","doi":"10.1016/j.siny.2023.101474","DOIUrl":"10.1016/j.siny.2023.101474","url":null,"abstract":"","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101474"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The physiology, assessment, and treatment of neonatal pain 新生儿疼痛的生理、评估和治疗
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101465
Megan H. Tucker , Priya Tiwari , Brian S. Carter
{"title":"The physiology, assessment, and treatment of neonatal pain","authors":"Megan H. Tucker ,&nbsp;Priya Tiwari ,&nbsp;Brian S. Carter","doi":"10.1016/j.siny.2023.101465","DOIUrl":"10.1016/j.siny.2023.101465","url":null,"abstract":"<div><p>Studies have clearly shown that development of pain receptors<span> starts as early as 20-weeks’ gestation. Despite contrary belief, the human fetus develops a similar number of receptive pain fibers as seen in adults. These receptors' maturation is based on response to sensory stimuli<span><span> received after birth which makes the </span>NICU<span><span> a critical place for developing central nervous system's </span>pain perception<span>. In practice, the assessment of pain relies mostly on bedside staff. In this review we will discuss the various developing features of pain pathways in the neonatal brain and the modification of pain perception secondary to various interactions immediately after birth. We also discuss the various tools utilized in the NICU for pain assessment that rely on physiological and behavioral patterns. Finally, we address the management of pain in the NICU by either pharmacological or non-pharmacological intervention while highlighting potential benefits, disadvantages, and situations where one may be preferred over another.</span></span></span></span></p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101465"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10537283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The logistics of withdrawing life-sustaining medical treatment in the neonatal intensive care unit 在新生儿重症监护室撤回维持生命的药物治疗的后勤
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-08-01 DOI: 10.1016/j.siny.2023.101443
Erin Rholl, Steven R. Leuthner
{"title":"The logistics of withdrawing life-sustaining medical treatment in the neonatal intensive care unit","authors":"Erin Rholl,&nbsp;Steven R. Leuthner","doi":"10.1016/j.siny.2023.101443","DOIUrl":"10.1016/j.siny.2023.101443","url":null,"abstract":"<div><p><span>Withdrawal of life sustaining medical treatments is a common mode of death in the </span>neonatal intensive care unit. Shared decision making and communication are crucial steps prior to, during and after a withdrawal of life sustaining medical treatments. Discussion should include the steps to occur during the withdrawal. Physicians should recommend appropriate withdrawal steps based on family goals. Stepwise approach should be taken only if a family requests. Care should continue for the family and staff after the withdrawal and the infant's death.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 4","pages":"Article 101443"},"PeriodicalIF":3.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10223651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Counseling for the option of termination of pregnancy for severe fetal anomalies in light of the recent Supreme Court ruling to remove the constitutional right to an abortion 根据最高法院最近取消宪法规定的堕胎权的裁决，为严重胎儿异常终止妊娠的选择提供咨询
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101441
Amos Grünebaum , Jonathan D. Moreno , Susan Pollet Esq , Frank A. Chervenak
{"title":"Counseling for the option of termination of pregnancy for severe fetal anomalies in light of the recent Supreme Court ruling to remove the constitutional right to an abortion","authors":"Amos Grünebaum ,&nbsp;Jonathan D. Moreno ,&nbsp;Susan Pollet Esq ,&nbsp;Frank A. Chervenak","doi":"10.1016/j.siny.2023.101441","DOIUrl":"10.1016/j.siny.2023.101441","url":null,"abstract":"<div><p>A birth defect<span><span> is a structural or chromosomal change present at birth<span> that can affect almost any part or parts of the body. Birth defects can vary from mild to severe. On June 24, 2022, with its Dobbs v Jackson Women's Health Organization decision the Supreme Court of the United States overturned Roe v. Wade, removing the longstanding landmark 1973 ruling that secured a person's constitutional right to an abortion. With this decision individual states can now decide their own abortion laws. In about one-half of the states that continue the legality of </span></span>pregnancy termination, the process of offering, discussing, and performing terminations of pregnancy remain the same as previously. In states where abortions are not legal, there will be conflicts between the law and the ethical responsibility of physicians to offer and discuss termination of pregnancy for severe anomalies.</span></p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101441"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9660107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Ethics at the end of life in the newborn intensive care unit: Conversations and decisions 新生儿重症监护病房生命末期的伦理学:对话与决定
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101438
Mark R. Mercurio , Lynn Gillam
{"title":"Ethics at the end of life in the newborn intensive care unit: Conversations and decisions","authors":"Mark R. Mercurio ,&nbsp;Lynn Gillam","doi":"10.1016/j.siny.2023.101438","DOIUrl":"10.1016/j.siny.2023.101438","url":null,"abstract":"<div><p><span><span>The unexpected birth of a critically ill baby raises many ethical questions for neonatologists. Some of these are obviously ethical questions, about whether to attempt resuscitation, and, if the baby is resuscitated and survives, whether to continue life sustaining interventions. Other ethical decisions are more related to what to say rather than what to do. Although less obvious, they are equally as important, and may also have far-reaching ramifications. This essay presents the story of a </span>newborn with profound hypoxic-ischemic encephalopathy, and reviews decisions regarding resuscitation, withdrawal of </span>mechanical ventilation, withdrawal of medically administered nutrition and hydration, and active euthanasia. An overview of the ethical issues at work at each decision point is presented, as well as guidance regarding discussions with parents throughout the process, including specific wording. This may serve as a helpful guide for ethical deliberation, and helpful scripting for parental discussion, in similar cases.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101438"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9604138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Paediatric palliative care in the NICU: A new era of integration 新生儿重症监护室的儿科姑息治疗:一体化的新时代
IF 3 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2023-06-01 DOI: 10.1016/j.siny.2023.101436
Sophie Bertaud , Angela M. Montgomery , Finella Craig
{"title":"Paediatric palliative care in the NICU: A new era of integration","authors":"Sophie Bertaud ,&nbsp;Angela M. Montgomery ,&nbsp;Finella Craig","doi":"10.1016/j.siny.2023.101436","DOIUrl":"10.1016/j.siny.2023.101436","url":null,"abstract":"<div><p>We are entering a new era of integration between neonatal medicine and paediatric palliative care<span>, with increasing recognition that the role and skills of palliative care<span><span> extend beyond care of only the terminally ill infant. This paper addresses the principles of paediatric palliative care and how they apply in the </span>NICU, considers who provides palliative care in this setting and outlines the key components of care. We consider how the international standards of palliative care pertain to neonatal medicine and how a fully integrated approach to care may be realised across these two disciplines.</span></span></p><p>Palliative care is so much more than end-of-life care, offering a proactive and holistic approach which addresses the physical, emotional, spiritual and social needs of the infant and family. This is a truly interdisciplinary endeavour, relying on a harmonisation of the skills from both the neonatal and palliative care teams to deliver high-quality coordinated care.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"28 3","pages":"Article 101436"},"PeriodicalIF":3.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9961343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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