Neonatal end-of-life care: a review of the research literature

Area of Science:

• Neonatal Medicine
• Palliative Care
• Bioethics

Background:

• Neonatal mortality remains high despite medical advances, with significant knowledge gaps regarding the care of critically ill infants.
• Palliative care is a crucial, yet underutilized, option for infants in the neonatal period and their families.
• Understanding the complexities of end-of-life care is essential for improving outcomes and support.

Purpose of the Study:

• To provide healthcare providers with an overview of palliative and end-of-life care for infants during the neonatal period (birth to 27 days).
• To synthesize current research on the needs and care of critically ill neonates requiring end-of-life support.

Main Methods:

• An integrative review of the current research literature was conducted.
• A total of 10 relevant articles were selected for analysis and synthesis.

Main Results:

• Findings were categorized into four key areas: practices of withdrawing or withholding life-sustaining treatment.
• Pain management during ventilator withdrawal was examined.
• The role of parents in the decision-making process and the infant's dying process were also summarized.

Conclusions:

• Palliative and end-of-life care are vital components of neonatal medicine that require further integration and research.
• Addressing the identified gaps in knowledge regarding treatment decisions, pain management, and family support is critical.
• Enhanced understanding and implementation of palliative care can improve the quality of life and death for neonates and their families.