Related Experiment Video
Updated: Aug 10, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Identifying futility in a neonatal intensive care unit setting
Shabih Manzar1, Arun K Nair, Mangalore G Pai
1Division of Neonatology, John Stroger Jr. Hospital of Cook County, 1901 W Harrison St, 4th Floor, Room 4509, Chicago, IL 60612, United States of America.
Insights
Futile care for infants with life-limiting conditions in the neonatal intensive care unit (NICU) consumed less than 8% of beds. Cost savings from limiting this care are negligible, indicating most NICU care is appropriate.
Area of Science:
- Neonatal Intensive Care
- Medical Ethics
- Healthcare Resource Allocation
Background:
- Caring for infants with non-survivable conditions presents ethical challenges.
- Intensive, ineffective care, termed "futile care," can significantly impact hospital expenditures.
- Understanding the extent of futile care in neonatal intensive care units (NICUs) is crucial for resource management.
Purpose of the Study:
- To determine the extent of futile care in a neonatal intensive care unit (NICU).
- To assess the resource consumption associated with futile care in neonates.
Main Methods:
- Retrospective review of neonates admitted to the NICU from April 2003 to September 2003.
- Identification of infants with conditions incompatible with life or meaningful survival.
- Utilized bed days as a metric for futile care and resource consumption.
Main Results:
- A total of 355 infants were admitted, accounting for 4452 patient bed days.
- Twenty-five infants met the criteria for futile care.
- The futile care group occupied 317 days (7.1%) of total NICU bed days.
Conclusions:
- Futile care accounted for less than 8% of NICU bed occupancy, indicating minimal resource consumption.
- Significant cost savings are unlikely from further restricting futile care in neonates.
- The study supports the ethical appropriateness of the majority of care provided to critically ill neonates.
Objective:
Caring for infants born with lesions that are either incompatible with life or conditions that will not allow meaningful survival is an ethical dilemma. Provision of intensive ineffective care to these infants may be labeled as "futile care" which can consume a major proportion of total hospital expenditure. We conducted the present study to look at the extent of futility in a neonatal intensive care unit (NICU) setting.
Methods:
All neonates with lesion either incompatible with life or conditions that will not allow meaningful survival admitted during April 2003 to September 2003 in the Neonatal Intensive Care Unit, Royal Hospital, Muscat, Sultanate of Oman, were reviewed to identify futility. Bed days were used as surrogate for extent of futile care and resource consumption.
Results:
A total of 355 infants were admitted to the NICU during the study period representing 4452 consecutive patient bed days. Twenty-five infants fulfilled the criteria of futility. Total length of stay of futile group was 317 (7.1%) days as compared to 4153 (92.8%) days in the non-futile group.
Conclusion:
The bed occupancy for futile care cases was less than 8% of all the NICU beds suggesting only a small proportion of resource consumption. Based on this, expecting cost savings from further limiting futile care in neonates is not warranted and is negligible. Ethically, we are assured that the majority of the care provided to our sick neonates are appropriate.
More Related Videos
06:04Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
Published on: July 4, 2018
11:27A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023